The Effect of Health Belief Modification Program on Polypharmacy Medication Adherence among Older Persons with Chronic Illness

Main Article Content

Titima Yinghan
Siriphan Sasat


            This research was a quasi-experimental, post-test with two comparative group study aimed to study the effect of health belief modification program on polypharmacy medication adherence among older persons with chronic illness. The purposive sampling consisted of 40 older persons and randomly divided into the control and experimental groups, 20 subjects for each group were paired with similar characteristics in terms of age and education level. The experimental group received health modification program for 5 weeks and the control group received conventional nursing care. The instruments were demographic questionnaire and the record from medication adherence. Inter-rater reliability statistics of the assessment was 1.0. The data were analyzed using descriptive statistics and Z-test.
            The result revealed that the proportion of medication adherence among older persons with chronic illness in the experimental group that received the health belief modification program was statistically significant higher than the control group who received conventional nursing care at the level of .05. The results of this study supported that utilizing the health belief modification can enhance the medication adherence among older persons with chronic illness with polypharmacy. Therefore, the health belief modification program could be applied as a guide for older persons with chronic illness to improve medication adherence.

Article Details

Research Article


United Nations. World population ageing 2019: highlights. [Internet]. [cited 2020 September 8]. Available from:

Foundation of Thai Gerontology Research and Development Institute. Situation of the Thai elderly 2018. Bangkok: Printery; 2018. (in Thai).

Aekplakan W. Thai National Health Examination Survey, NHES V. Nonthaburi: Health Systems Research Institute (HSRI); 2014. (in Thai).

Tepsuriyanont S, Jirapaet V, Luangamornlert S, Praditsuwan R. Relationship between regimen complexity and medication adherence behavior in Thai elderly with hypertension. Chula Med J 2011;55(5):457-72. (in Thai).

Gnjidic D, Hilmer SN, Blyth FM, Naganathan V, Waite L, Seibel MJ, et al. Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. J Clin Epidemiol 2012;65(9):989-95.

Vatcharavongvan P, Puttawanchai V. Polypharmacy, medication adherence and medication management at home in elderly patients with multiple non-communicable diseases in Thai primary care. Family Medicine & Primary Care Review 2017;19(4):412-6.

Buakhwan W. Roles of pharmacist in geriatric medication management at Ban Bang Khae welfare development center for older persons. [Master’s Thesis, Faculty of Phamaceutical Sciences]. Chulalongkorn University; 2015. (in Thai).

Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005;353(5):487-97.

Saxon SV, Perkins EA, Etten MJ. Physical change and aging: a guide for the helping professions. 6th ed. New York: Springer; 2015.

Maher RL, Hanlon JT, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf 2014;13(1):10.1517/14740338.2013.827660.

Yap AF, Thirumoorthy T, Kwan YH. Medication adherence in the elderly. Journal of Clinical Gerontology and Geriatrics 2016;7(2):64-7.

Zelko E, Klemenc-Ketis Z, Tusek-Bunc K. Medication adherence in elderly with polypharmacy living at home: a systematic review of existing studies. Mater Sociomed 2016;28(2):129-32.

Lai X, Zhu H, Huo X, Li Z. Polypharmacy in the oldest old (≥80 years of age) patients in China: a cross-sectional study. BMC Geriatrics 2018;18(1):64.

Yap AF, Thirumoorthy T, Kwan YH. Systematic review of the barriers affecting medication adherence in older adults. Geriatr Gerontol Int 2016;16(10):1093-101.

Shruthi R, Jyothi R, Pundarikaksha HP, Nagesh GN, Tushar TJ. A study of medication compliance in geriatric patients with chronic illnesses at a tertiary care hospital. J Clin Diagn Res 2016;10(12):FC40-FC43.

Jin H, Kim Y, Rhie SJ. Factors affecting medication adherence in elderly people. Patient Preference and Adherence 2016;10:2117-25.

Rungsawang S. Factors related to polypharmacy medication adherence among older persons with chronic illness. Journal of Nursing, Siam University 2017;18(35):6-23. (in Thai).

Manadee C, Ploylearmsang C, Sookaneknun P. Effects of elderly care with chronic diseases on quality use of medicine at home in area of sub-district health promoting hospitals, Somdet district, Kalasin province. IJPS 2014;10(3):354-71. (in Thai).

Kumpiriyapong N, Sasat S. The effect of health belief programme on medicine used behavior in older persons with hypertension. Royal Thai Navy Medical Journal 2017;44(3):67-83. (in Thai).

Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the health belief model. Health Educ Q 1988;15(2):175-83.

Burns N, Grove SK. The practice of nursing research: appraisal, synthesis and generation of evidence. 6th ed. St. Louis, Mo: Elsevier Saunders; 2009.

Collin C, Wade DT, Davies S, Horne V. The Barthel ADL Index: a reliability study. International Disability Studies 1988;10(2):61-3.

Jitapankul S. Principles of geriatric medicine. 3rd ed. Bangkok: CU Print; 2001. (in Thai).

Institute of Geriatric Medicine. MMSE-Thai 2002. Bangkok: Ministry of Public Health; 2002. (in Thai).

Sakthong P, Sonsa-Ardjit N, Sukarnjanaset P, Munpan W, Suksanga P. Development and psychometric testing of the medication taking behavior tool in Thai patients. Int J Clin Pharm 2016;38(2):438-45.

Woodham NS. Intelligent pill box to improve medical adherence in elderly with hypertension: a randomized controlled trial. [Doctoral Dissertation, College of Public Health Sciences]. Chulalongkorn University; 2017. (in Thai).

Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clinic Proceedings 2011;86(4):304-14.

Promjame S, Kespichayawattana J. The effect of health belief model program on complication preventive behavior in hypertensive older persons. Royal Thai Navy Medical Journal 2018;45(3):561-77. (in Thai).

Zamani N, Ahmadi Tabatabaei SV, Khanjani N, Fadakar Davarani MM. The effect of educational intervention based on the health belief model on medication adherence among patients with diabetes referred to a diabetes Center in Zarand, Kerman. Journal of Health and Development 2017;6(2):97-109.