Factors Influencing Medication Adherence in Hypertensive Patients without Complications
Main Article Content
Abstract
A predictive research design was applied in this study and aimed to examine the medication adherence and its influencing factors in hypertensive patients without complications. Ninety-seven participants were recruited by a simple random sampling method. The research instruments comprised of 6 questionnaires including a demographic questionnaire, basic health literacy questionnaire, patient-healthcare provider interpersonal relationship questionnaire, perceptions of hypertension questionnaire, perceived self-efficacy to medication adherence questionnaire, and medication adherence questionnaire. Descriptive statistics and multiple regression analysis were used to analyze the data.
The results showed that 40.2% of the participants had a low level of medication adherence (Mean = 5.95, SD = 1.66). The health literacy, patient-healthcare provider interpersonal relationship, perceptions of hypertension, and perceived self-efficacy to medication adherence explained 28.5% in the variance of medication adherence among hypertensive patients without complications. However, the participants in this study had no complication from hypertension and the study had not been examined comprehensively based on the multidimensional adherence model, thus the generalization of the results is limited. The model suggested that health literacy (β = .24, p = < .05) and perceived self-efficacy to medication adherence (β = .24, p = < .05) were the best influencing factors to medication adherence. The patient-healthcare provider interpersonal relationship and perceptions of hypertension were the factors that followed health literacy and perceived self-efficacy influencing the medication adherence (β = .22, p = < .05, and β = .18, p = < .05, respectively).
The knowledge gained from this study suggested that the nursing intervention to promote medication adherence should emphasize on perceptions of self-efficacy to medication adherence, health literacy, self-awareness on hypertension, and interpersonal relationship between patients and healthcare providers. The intervention may be beneficial for the patients with hypertension by triggering their self-awareness and reminding the importance of medication adherence. The future research may focus on other factors based on the multidimensional adherence model including condition-related factors, and therapy-related factors. The examination of these factors may provide a useful knowledge for developing a guideline of medication adherence among hypertensive patients. We believe that the guideline may encourage patients to take the medication effectively and comprehensively.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
World Health Organization. Hypertension. [Internet]. [cited 2019 March 5]. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension.
Zhang Y, Li X, Mao L, Zhang M, Li K, Zheng Y, et al. Factors affecting medication adherence in community-managed patients with hypertension based on the principal component analysis: evidence from Xinjiang, China. Dove Medical Press 2018;12(1):803-12.
Singh S, Shankar R, Singh GP. Prevalence and associated risk factors of hypertension: a cross-sectional study in Urban Varanasi. International Journal of Hypertension 2017;15(10):1-10.
Thai Hypertension Society. 2019 Thai guidelines on the treatment of hypertension. Bangkok: Trickthink; 2019. (in Thai).
Division of Non Communicable Disease. Hypertension: measure first, know first, can prevent. [Internet]. [cited 2019 March 5]. Available from: https://www.ddc.moph.go.th/
uploads/publish/962020191223152713.pdf. (in Thai).
Dzau VJ, Balatbat CA. Future of hypertension: the need for transformation. Hypertension 2019;74(3):450-7.
Sinsap N, Jankra J, Jaiman B. Hypertension is elderly: silence killer should be aware. Journal of Phrapokklao Nursing College 2017;28(1):100-9. (in Thai).
Thai Hypertension Society Hypertension in diabetic patients. [Internet]. [cited 2021 May 25]. Available from: http://www.thaihypertension.org/files/11.08Dec200618-AttachFile 1165550538.pdf. (in Thai).
Park S. Ideal target blood pressure in hypertension. Korean Circ J 2019;49(11):1002-9.
Asgedom SW, Atey TM, Desse TA. Antihypertensive medication adherence and associated factors among adult hypertensive patients at Jimma University Specialized Hospital, southwest Ethiopia. Biomed Central Research Notes 2018;11(1):1-8.
Boratas S, Kilic HF. Evaluation of medication adherence in hypertensive patients and influential factors. Pakistan Journal of Medical Sciences 2018;34(4):959-63.
World Health Organization. Adherence to long–term therapies evidence for action. Geneva World Health Organization; 2003.
Kim HJ, Yoon SJ, Oh IH, Lim JH, Kim YA. Medication adherence and the occurrence of complications in patients with newly diagnosed hypertension. Korean Circulation Journal 2016;46(3):384-93.
Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation 2016;134(6):441-50.
Burnier M, Egan BM. Adherence in hypertension: a review of prevalence, risk factors, impact, and management. Circulation Research 2019;29(7):1124-40.
Vrijens B, Antoniou S, Burnier M, de la Sierra A, Volpe M. Current situation of medication adherence in hypertension. Frontiers in Pharmacology 2017;1(8):1-6.
Puengdokmai P, Charoenkitkarn V, Pinyopasakul W, Sriprasong S, Dumavibhat C. Factors influencing medication adherence in hypertensive patients without complications. Princess of Naradhiwas University Journal 2015;8(1):16-24. (in Thai).
Wangworatrakul W, Suwannaroop N, Moopayak K. Factors predicting to medication adherence among patients with essential hypertension. Journal of The Royal Thai Army Nurses 2017;18(1):131-8. (in Thai).
Sadoyoo S, Jirapreeya N, Treesak C, Sangjam P. Leftover medications in patients with chronic diseases from home health care visits: a community study in Bangkok. Dialogue on Pharmacy and Health Care Practice 2014;1(1):1-7. (in Thai).
Guerra AF, Rodriguez-Lopez L, Vargas-Ayala G, Huerta-Ramirez S, Serna DC, Lozano-Nuevo JJ. Depression increases the risk for uncontrolled hypertension. Experimental & Clinical Cardiology 2013;18(1):10-2.
Arindari DR, Jerayingmongkol P, Sanguanprasit B. Factors related to medication adherence among hypertensive patients in Muara Enim, Indonesia. Anpor Annual Conference 2015;12(1):3-7.
Lahkaew A, Chaleekroa T. Health literacy and factors related to medication among patients with hypertension, Ban Piang Luang sub-district health promoting hospital, Chiang Mai province. In: The 6th NEU National and International Conference 2019 (NEUNIC 2019): educational innovation for sustainable society development. July 20, 2019. Nouthestern University, Khon Kean. (in Thai).
Chipidza FE, Wallwork RS, Stern TA. Impact of the doctor-patient relationship. The Primary Care Companion for CNS Disorders 2015;17(5):15-8.
Murray B, McCrone S. An integrative review of promoting trust in the patient–primary care provider relationship. Journal of Advanced Nursing 2015;71(1):3-19.
Mahmoudian A, Zamani A, Tavakoli N, Farajzadegan Z, Fathollahi-Dehkordi F. Medication adherence in patients with hypertension: does satisfaction with doctor-patient relationship work?. Journal of research in medical sciences: the official. J Res Med Sci 2017;22:48. doi: 10.4103/jrms.JRMS_205_16. eCollection 2017.
Saleema L, Panpakdee O, Arpanantikul M, Chai-Aroon T. The influence of basic conditioning factors and self-care agency on self-care behaviors in Thais with hypertension. Pacific Rim Int J Nurs Res 2016;20(1):5-17.
Rusawang S. Factor related to polypharmacy medication adherence among older persons with chronic illness. Journal of Nursing, Siam University 2017;18(35):6-23. (in Thai).
Prakobchai S, Ayuthya SK, Wattanakitkrileart D, Buranakitjaroen P. Factors influencing medication-taking behavior of hypertensive patients. Nursing Science Journal of Thailand 2014;32(4):43-51. (in Thai).
Ellis PD. The essential guide to effect sizes: statistical power, meta-analysis, and the interpretation of research results. Cambridge University Press; 2010.
Chaiyata A, Numkhum L, Rakkapao N. The relationship between health literacy, medication intake, and doctor’s appointment behavior among patients with diabetes mellitus and hypertension in Lamphun province. Thai Science and Technology Journal 2020;28(1):182-93. (in Thai).
Kamsam A. Health belief and compliance behavior with prescribed medication among people with hypertension at Thakham District Health Promoting Hospital, Mueang district, Phrae province. [Master’s Thesis, Faculty of Public Health]. Chiang Mai University; 2015. (in Thai).
Ogedegbe G, Mancuso CA, Allegrante JP, Charlson ME. Development and evaluation of a medication adherence self-efficacy scale in hypertensive African-American patients. J Clin Epidemiol 2003;56(6):520-9.
Ruangthip T, Wattanakitkrileart D, Charoenkitkarn V, Dumavibhat C. Factors influencing medication adherence in patients with chronic heart failure. Royal Thai Navy Medical Journal 2017;44(4):51-63. (in Thai).
Thongma P. Health literacy and health outcomes in hypertensive patients. Thai Red Cross Nursing Journal 2020;13(1):50-62. (in Thai).