Korean J Health Promot.  2015 Sep;15(3):121-128. 10.15384/kjhp.2015.15.3.121.

Medication Adherence and its Predictors in Community Elderly Patients with Hypertension

Affiliations
  • 1Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
  • 2Department of Preventive Medicine and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea. parkks@gnu.ac.kr
  • 3Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, Jinju, Korea.

Abstract

BACKGROUND
Medication adherence is important for hypertension management but still stay low level. It is reasonable method to classify medication nonadherence into intentional nonadherence and unintentional nonadherence and manage it according to this categories. This study aimed to explore medication adherence and its predictors in community patients with hypertension, especially dividing into intentional nonadherence and unintentional nonadherence.
METHODS
Study subjects included 1,988 patients who were prescribed hypertension drugs among 2012 community health survey subjects of 10 cities in Gyeongsangnamdo and we analyzed medication adherence with hypertension and its predictors. We conducted chi-square test for nominal variable and ANOVA test for continuous variable and use multinominal regression to analyze independent predictors of intentional nonadherence and unintentional nonadherence in contrast to medication adherence.
RESULTS
Of the 1,988 patients, 49.7% were adherent, 26.1% were unintentionally nonadherent and 24.2% intentionally nonadherent. Independent predictors of unintentional nonadherence were depressive symptoms (odds ratio [OR]=1.696, P=0.047) and arthritis (OR=1.319, P=0.030) and independent predictors of intentional nonadherence were cardiocerebrovascular disease (OR=1.464, P=0.044), self-efficacy (OR=0.984, P=0.007), beliefs about medications questionnaire (necessity [OR=0.834, P<0.001] and concern [OR=1.236, P<0.001]).
CONCLUSIONS
In order to manage hypertension in community, improvement in medication adherence is needed. Depressive symptom and self-efficacy need to be managed, but especially patients'beliefs about their medication need to be considered to improve intentional nonadherence.

Keyword

Medication adherence; Hypertension; Intention

MeSH Terms

Aged*
Arthritis
Depression
Gyeongsangnam-do
Health Surveys
Humans
Hypertension*
Intention
Medication Adherence*

Cited by  1 articles

Factors Related to Medication Adherence in Adult Patients with Tuberculosis
Eun Young Jung, Sun-Kyung Hwang
Korean J Adult Nurs. 2018;30(5):493-503.    doi: 10.7475/kjan.2018.30.5.493.


Reference

1.Sabaté E. Adherence to long-term therapies: evidence for action. Geneva, Switzerland: World Health Organization;2003.
2.Knight EL., Bohn RL., Wang PS., Glynn RJ., Mogun H., Avorn J. Predictors of uncontrolled hypertension in ambulatory patients. Hypertension. 2001. 38(4):809–14.
Article
3.DiMatteo MR., Giordani PJ., Lepper HS., Croghan TW. Patient adherence and medical treatment outcomes: a meta-analysis. Med Care. 2002. 40(9):794–811.
4.Simpson SH., Eurich DT., Majumdar SR., Padwal RS., Tsuyuki RT., Varney J, et al. A meta-analysis of the association between adherence to drug therapy and mortality. BMJ. 2006. 333(7557):15.
Article
5.Bae S., Kim J., Min K., Kwon S., Han D. Patient compliance and associated factors in the community-based hypertension control program. Korean J Prev Med. 1999. 32(2):215–27.
6.Lee SW., Kam S., Chun BY., Yeh MH., Kang YS., Kim KY, et al. Therapeutic compliance and its related factors of patients with hypertension in rural area. Korean J Prev Med. 2000. 33(2):215–25.
7.Lim BD., Chun BY., Kam S., Im JS., Park SW., Park JH. Annual visit days, prescription days and medical expenses of hypertensive patients. Korean J Prev Med. 2002. 35(4):340–50.
8.Park JH. Antihypertensive drug medication adherence of national health insurance beneficiaries and its affecting factors in Korea [dissertation]. Seoul: Seoul National University;2006.
9.Lehane E., McCarthy G. Intentional and unintentional medication non-adherence: a comprehensive framework for clinical research and practice? A discussion paper. Int J Nurs Stud. 2007. 44(8):1468–77.
Article
10.Hugtenburg JG., Timmers L., Elders PJ., Vervloet M., van Dijk L. Definitions, variants, and causes of nonadherence with medication: a challenge for tailored interventions. Patient Prefer Adherence. 2013. 7:675–82.
Article
11.Wroe AL. Intentional and unintentional nonadherence: a study of decision making. J Behav Med. 2002. 25(4):355–72.
12.Lowry KP., Dudley TK., Oddone EZ., Bosworth HB. Intentional and unintentional nonadherence to antihypertensive medication. Ann Pharmacother. 2005. 39(7-8):1198–203.
Article
13.Horne R., Weinman J., Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychology and health. 1999. 14(1):1–24.
Article
14.Horne R., Chapman SC., Parham R., Freemantle N., Forbes A., Cooper V. Understanding patients' adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. PLoS One. 2013. 8(12):e80633.
Article
15.Jung JH., Kim YH., Han DJ., Kim KS., Chu SH. Medication adherence in patients taking immunodepressants after kidney transplantation. J Korean Soc Tranplant. 2010. 24(4):289–97.
16.Lee JK. Factors associated with drug misuse behaviors among polypharmacy elderly. Korean J Adult Nurs. 2011. 23(6):554–63.
17.Kang H. A guide on the use of factor analysis in the assessment of construct validity. J Korean Acad Nurs. 2013. 43(5):587–94.
Article
18.Ho PM., Bryson CL., Rumsfeld JS. Medication adherence: its importance in cardiovascular outcomes. Circulation. 2009. 119(23):3028–35.
19.Morisky DE., Green LW., Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986. 24(1):67–74.
Article
20.Morisky DE., Ang A., Krousel-Wood M., Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008. 10(5):348–54.
Article
21.Osterberg L., Blaschke T. Adherence to medication. N Engl J Med. 2005. 353(5):487–97.
Article
22.Bae SS., Lee IS., Kim SM., Woo SO., Lee YJ., Kim BY, et al. Factors affecting patients compliance with antihypertensive medication in a rural area. Korean J Health Policy Admin. 1994. 4(1):25–48.
23.Kim JR., Moon JK., Kang KH., Lee MS., Hong DY. Community-based follow-up study of the compliance and its determinants in hypertension. J Korean Public Health Assoc. 1997. 23(1):79–100.
24.Yang BG. 2013 Health behavior and chronic disease statistics. Cheongju, Korea: Center for Disease Control and Prevention;2014. p. 24–25.
25.Horne R., Weinman J. Self-regulation and self-management in asthma: exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication. Psychology and Health. 2002. 17(1):17–32.
Article
26.Leventhal H., Weinman J., Leventhal EA., Phillips LA. Health Psychology: the Search for Pathways between Behavior and Health. Annu Rev Psychol. 2008. 59:477–505.
Article
27.DiMatteo MR., Lepper HS., Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000. 160(14):2101–7.
28.Barat I., Andreasen F., Damsgaard EM. Drug therapy in the elderly: what doctors believe and patients actually do. Br J Clin Pharmacol. 2001. 51(6):615–22.
Article
29.Persaud R. Both sides need to keep the relationship going. BMJ. 2003. 326(7402):1337.
Article
Full Text Links
  • KJHP
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr