J Korean Acad Community Health Nurs.  2012 Jun;23(2):189-200. 10.12799/jkachn.2012.23.2.189.

Factors Influencing the Stages of Change in Medication Adherence in Patients with Hypertension

• Byeon YS
• Kim SO
• Cho JH

• KMID: 2292808
• DOI: http://doi.org/10.12799/jkachn.2012.23.2.189

Abstract

PURPOSE
The purpose of this study is to identify factors associated with the stages of change in medication adherence in patients with hypertension.
METHODS
Participants were 323 patients with hypertension. Sociodemographic/medication-related characteristics, stages of change, processes of change, self efficacy and decisional balance were self-administered.
RESULTS
Stages of change were significantly different according to gender, age, job and living arrangement. A multinominal logistic regression analysis has revealed that gender, age, living arrangement, self-liberation, and self-efficacy were significantly associated with the precontemplation stage. Age and self-liberation were significantly associated with the contemplation stage. Gender, age, living arrangement, and self-liberation were significantly associated with the preparation stage. Gender and helping relationship were significantly associated with the action stage. This model explained 52.0% of the stages of change in medication adherence.
CONCLUSION
The tailored intervention strategies based on the stages of change may be needed for improving medication adherence in patients with hypertension.

Keyword

Hypertension; Medication adherence

MeSH Terms

Humans
Hypertension
Logistic Models
Medication Adherence
Residence Characteristics
Self Efficacy

Reference

1. Adams KB, Sanders S, Auth EA. Loneliness and depression in independent living retirement communities: Risk and resilience factors. Aging Ment Health. 2004. 8:475–485.

2. Ahn SY. Medication compliance of recently discharged elderly patients. Unpublished master's thesis. 1999. Seoul: Seoul National University.

3. Barat I, Andreasen F, Damsgaard EM. Drug therapy in the elderly: What doctors believe and patients actually do. Br J Clin Pharmacol. 2001. 51:615–622.

4. Bramley TJ, Gerbino PP, Nightengale BS, Frech-Tamas F. Relationship of blood pressure control to adherence with antihypertensive monotheraphy in 13 managed care organization. J Manag Care Pharm. 2006. 12:239–245.

5. Cha SS. A study on compliance of hypertensive patients registered at primary health care post. Unpublished master's thesis. 2005. Daejeon: Konyang University.

6. Chang KO. The relationship among health habits, perceived health status and knowledge related to hypertension and medication compliances of hypertensive elderly. Unpublished master's thesis. 2003. Busan: Catholic University of Pusan.

7. Cohen J. Statistical power analysis for the behavioral science. 1988. 2nd ed. New York: Academic Press.

8. Glanz K, Rimer BK, Viswanath K. Health behavior and health education. 2008. 4th ed. San Francisco: Jossey-Bass.

9. Han KS. Relationship of blood pressure control with healthy lifestyle practice and medication adherence of hypertensive patients. Unpublished master's thesis. 2009. Jeonju: Chonbuk National University.

10. Hong MY. A study on the medication compliance of the hypertension patients. Unpublished master's thesis. 1999. Seoul: Seoul National University.

11. Kim JL. Adverse drug reactions of psychotropics in the elderly. J Korean Soc Biol Ther Psychiatry. 2001. 9(1):9–17.

12. Kim JS, Lee SO. Differences in processes of change, decisional balance, situational temptation and commitment to quitting smoking across the smoking cessation stage of change. J Korean Data Anal Soc. 2011. 12(2):825–838.

13. Kim KE. Development and effect of a reducing alcohol intervention program for workers. Unpublished doctoral dissertation. 2006. Seoul: Yonsei University.

14. Kim SH. Development and evaluation of transtheoretical model based exercise behavior intervention for older adults with hypertension. Unpublished doctoral dissertation. 2011. Seoul: Seoul National University.

15. Kim YI, Lee CH. Factors related to regular mammography screening for outpatients. J Korean Acad Community Health Nurs. 2007. 18(3):420–430.

16. Kim YO. Medication compliance and depression in older hypertensive adults. Unpublished master's thesis. 2008. Seoul: Chung-Ang University.

17. Korea Ministry of Health and Welfare, & Korea Center for Disease Control and Prevention. 2010 Korea national health and nutrition examination survey statistics: The 5th Korea national health and nutrition examination survey. 2011. Seoul: Korea Ministry of Health and Welfare, & Korea Center for Disease Control and Prevention.

18. Lee HJ. Factors affecting medication compliance of hypertensive patients. Unpublished master's thesis. 2002. Cheonan: Dankook University.

19. Lee HK. Relationships of psychological variables with the stages of exercise behavior based on transtheoretical model: Comparison of three age groups. Unpublished master's thesis. 2006. Seoul: Industry & Engineering Seoul National University.

20. Lee YJ, Lim NY. A study on the stage of change of exercise behavior and related factors in patients with chronic arthritis. J Korean Acad Fundam Nurs. 2006. 13(3):409–418.

21. Marentette MA, Gerth WC, Billings DK. Antihypertensive persistence and drug class. Can J Cardiol. 2002. 18:649–656.

22. Nicholas LMW. Determinants of adherence in women managing chronic health conditions. Unpublished doctoral dissertation. 2004. New York, USA: University of Rochester.

23. Nunnally JC. Psychometric theory. 1978. 2nd ed. New York: McGraw-Hill.

24. Oh HJ. Factors affecting medication adherence in the elderly people with chronic disease. Unpublished master's thesis. 2011. Daegu: Kyungpook National University.

25. Prochaska JO, DiClemente CC. Stage and process of self-change of smoking: toward and intergrative model of change. J Consult Clin Psychol. 1983. 51(3):390–395.

26. Prochaska JO, Velicer WF, DiClemente CC, Fava J. Measuring process of change: applications to the cessation of smoking. J Consult Clin Psychol. 1988. 56(4):520–528.

27. Takiya L, Peterson AM, Finley R. Meta-analysis of interventions for medication adherence to antihypertensives. Ann Pharmacother. 2004. 38:1617–1624.

28. Velicer WF, Diclemente CC, Prochaska JO, Bradenburg N. Decisional balance measure for assessing and predicting smoking status. J Pers Soc Psychol. 1985. 48(5):1279–1289.

29. Willey C, Redding C, Stafford J, Garfield F, Geletko S, Flanigan T, et al. Stages of change for adherence with medication regimens for chronic disease: Development and validation of a measure. Clin Ther. 2000. 22(7):858–871.