Factors Explaining Medication Adherence of Older Adults with Hypertension: A Cross-sectional Study

Authors

  • Luu Thi Thuy PhD (Candidate), Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital and Faculty of Nursing, Mahidol University, Thailand and Lecturer, Faculty of Nursing, Da Nang University of Medical Technology and Pharmacy, Vietnam.
  • Supreeda Monkong PhD (Nursing), Associate Professor, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Renu Pookboonmee DNS , Associate Professor, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Sirirat Leelacharas PhD (Nursing), Assistant Professor, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Chukiat Viwatwongkasem PhD (Statistics), Associate Professor, Department of Biostatistics, Faculty of Public Health, Mahidol University, Thailand.

Keywords:

Medication adherence, Older adults, Hypertension, Vietnam

Abstract

                Medication adherence plays a crucial role to control hypertension especially in older adults who are confronted with several challenges to effective pharmacotherapy. However, medication adherence in older people varies widely because of the influence of many factors. This study examined the factors of medication regimen complexity, physical function, social support, health literacy, patient-provider communication, health belief, and self-efficacy in explaining medication adherence of older people with hypertension. Three hundred people aged 60 years and older diagnosed with hypertension were recruited from outpatient departments of four hospitals in Vietnam. Nine questionnaires were used for collecting data: a demographic data form, Hill-Bone Compliance Scale, Medication Regimen Complexity Index, Lawton Instrumental Activities of Daily Living Scale, Multidimensional Scale of Perceived Social Support, Short-Form Health Literacy Questionnaire, Communication subscale of the Interpersonal Processes of Care Survey, Health Belief for Hypertensive Patient Scale,and Medication Adherence Self-Efficacy Scale-Revised. Data analysis was conducted using descriptive statistics, Pearson’s correlation, and hierarchical regression analysis.
                  The results indicated that self-efficacy, appropriate health belief, patient-provider communication, and medication regimen complexity jointly and significantly explained 39.9% of the variation in medication adherence. This finding suggests that nurses can develop interventions to enhance medication adherence by improving communication between patients and healthcare providers, providing instructions to clarify patients’ understanding regarding hypertension and medication, and increasing their confidence in medication administration.

References

Anker D, Santos-Eggimann B, Santschi V, Del Giovane C, Wolfson C, Streit S, et al. Screening and treatment of hypertension in older adults: Less is more? Public Health Rev. 2018;39(1):26. doi:10.1186/s40985-018-0101-z

Pont L, Alhawassi T. Challenges in the management of hypertension in older populations. In: Islam MS, editor. Hypertension: From basic research to clinical practice. Switzerland: Springer; 2017. p. 167-180.

Hien HA, Tam NM, Tam V, Derese A, Devroey D. Prevalence, awareness, treatment, and control of hypertension and its risk factors in (Central) Vietnam. Int J Hypertens. 2018; 2018:6326984. doi:10.1155/2018/6326984.

Burnier M, Egan BM. Adherence in hypertension. Circ Res. 2019;124(7):1124-1140. doi: 10.1161/CIRCRESAHA.118.313220.

Jin H, Kim Y, Rhie SJ. Factors affecting medication adherence in elderly people. Patient preference and adherence. 2016;10:2117-2125. doi: 10.2147/PPA.S118121

Saqlain M, Riaz A, Malik MN, Khan S, Ahmed A, Kamran S, et al. Medication adherence and its association with health literacy and performance in activities of daily livings among elderly hypertensive patients in Islamabad, Pakistan. Medicina (Kaunas). 2019;55(5):163. doi: 10.3390/medicina55050163.

Yang S, He C, Zhang X, Sun K, Wu S, Sun X, et al. Determinants of antihypertensive adherence among patients in Beijing: Application of the Health Belief Model. Patient Educ Couns. 2016;99(11):1894-1900. doi:10.1016 /j.pec.2016.06.014.

Nguyen T-P-L, Schuiling-Veninga CCM, Nguyen TBY, Vu T-H, Wright EP, Postma MJ. Adherence to hypertension medication: Quantitative and qualitative investigations in a rural Northern Vietnamese community. PLoS One. 2017; 12(2):e0171203. doi: 10.1371/journal.pone.0171203

Namwong A, Panuthai S, Suwanprapisa T, Khampolsiri T. A Casual model of adherence to therapeutic regimens among Thai older adults with hypertension. Pacific Rim Int J of Nurs Res. 2015;19(2):107-121. Available from: https://www.tci-thaijo.org/index.php/PRIJNR/article/view/22056

Meinema JG, van Dijk N, Beune EJAJ, Jaarsma DADC, van Weert HCPM, Haafkens JA. Determinants of adherence to treatment in hypertensive patients of African Descent and the role of culturally appropriate education. PLoS One. 2015;10(8):e0133560. doi:10.1371/journal.pone. 0133560.

Wannasirikul P, Termsirikulchai L, Sujirarat D, Benjakul S, Tanasugarn C. Health literacy, medication adherence, and blood pressure level among hypertensive older adults treated at primary health care centers. Southeast Asian J Trop Med Public Health. 2016;47(1):109-120.

Yap AF, Thirumoorthy T, Kwan YH. Systematic review of the barriers affecting medication adherence in older adults. Geriatr Gerontol Int. 2016;16(10):1093-1101. doi:10.1111/ggi.12616.

Al-Noumani H, Wu J-R, Barksdale D, Sherwood G, AlKhasawneh E, Knafl G. Health beliefs and medication adherence in patients with hypertension: A systematic review of quantitative studies. Patient Educ Couns. 2019; 102(6):1045-1056. doi: 10.1016/j.pec.2019.02.022

Yue Z, Li C, Weilin Q, Bin W. Application of the Health Belief Model to improve the understanding of antihypertensive medication adherence among Chinese patients. Patient Educ Couns. 2015;98(5):669-673. doi: 10.1016/j. pec.2015.02.007

Lo SHS, Chau JPC, Woo J, Thompson DR, Choi KC. Adherence to antihypertensive medication in older adults with hypertension. The Journal of Cardiovascular Nursing. 2016;31(4):296-303. doi: 10.1097/JCN.0000000000000251

Vrijens B, Antoniou S, Burnier M, de la Sierra A, Volpe M. Current situation of medication adherence in hypertension. Front Pharmacol. 2017;8:100. doi: 10.3389/fphar.2017.00100

Sabaté E. Adherence to long-term therapies- evidence for action. Geneva, Switzerland: WHO; 2003. 198 p.

Marengoni A, Monaco A, Costa E, Cherubini A, Prados-Torres A, Muth C, et al. Strategies to improve medication adherence in older persons: Consensus statement from the Senior Italia Federanziani Advisory Board. Drugs Aging. 2016; 33(9):629-637. doi: 10.1007/s40266-016-0387-9

George J, Phun YT, Bailey MJ, Kong DC, Stewart K. Development and validation of the Medication Regimen Complexity Index. Ann Pharmacother. 2004;38(9):1369-1376. doi:10.1345/aph.1D479.

Wimmer BC, Cross AJ, Jokanovic N, Wiese MD, George J, Johnell K, et al. Clinical outcomes associated with medication regimen complexity in older people: A systematic review. J Am Geriatr Soc. 2017;65(4):747-753. doi: 10.1111/jgs.14682

Lawton MP, Brody EM. Assessment of older people:Self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179-186. doi:10.1093/geront/9.3_Part_1.179

Leung DY, Bai X, Leung AY, Liu BC, Chi I. Prevalence of medication adherence and its associated factors among community-dwelling Chinese older adults in Hong Kong. Geriatr Gerontol Int. 2015;15(6):789-796. doi:10.1111/ggi.12342.

Zimet GD, Dahlem NW, Zimet SG, Farley GK. The Multidimensional Scale of Perceived Social Support. J Pers Assess. 1988;52(1):30-41.

Pinprapapan E, Panuthai S, Vannarit T, Srisuphan W. Casual model of adherence to therapeutic regimens among Thais with hypertension. Pacific Rim Int J of Nurs Res. 2013;17(3):268-81.

Sorensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health. 2012;12(1):80. doi:10.1186/1471-2458-12-80.

Mayo-Gamble TL, Mouton C. Examining the association between health literacy and medication adherence among older adults. Health Commun. 2018;33(9):1124-1130.doi:10.1080/10410236.2017.1331311.

Ueno H, Ishikawa H, Suzuki R, Izumida Y, Ohashi Y, Yamauchi T, et al. The association between health literacy levels and patient-reported outcomes in Japanese type 2

diabetic patients. SAGE Open Med. 2019;7:2050312119865647. doi: 10.1177/2050312119865647

Shiyanbola OO, Unni E, Huang Y-M, Lanier C. The association of health literacy with illness perceptions, medication beliefs, and medication adherence among

individuals with type 2 diabetes. Research in Social and Administrative Pharmacy. 2018;14(9):824-30. doi:10.1016/j.sapharm.2017.12.005

Stewart AL, Nápoles-Springer AM, Gregorich SE, Santoyo-Olsson J. Interpersonal Processes of Care Survey:Patient-reported measures for diverse groups. Health Serv

Res. 2007;42(3 Pt 1):1235-1256. doi:10.1111/j.1475-6773.2006.00637.x.

Hayden J. Health belief model. In: Hayden J, editor. Introduction to Health Behavior Theory. Burlington, MA:Jones & Bartlett; 2009. p. 31-44.

Brooke P, Bullock R. Validation of a 6 item cognitive impairment test with a view to primary care usage. Int J Geriatr Psychiatry. 1999;14(11):936-940. doi:10.

/(SICI)1099-1166(199911)14:113.0.CO;2-1.

Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. U.S: Lawrence Erlbaum Associates;1988. 579 p.

Zhang NJ, Terry A, McHorney CA. Impact of health literacy on medication adherence: A systematic review and meta-analysis. Ann Pharmacother. 2014;48(6):741-

doi:10.1177/1060028014526562.

Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: A clear and user-friendly guideline. J Eval Clin Pract. 2011;17(2):268-274. doi:10.1111/j.1365-2753.2010.01434.x.

Kim MT, Hill MN, Bone LR, Levine DM. Development and testing of the Hill-Bone Compliance to High Blood Pressure Therapy Scale. Prog Cardiovasc Nurs. 2000; 15(3):90-96. doi:10.1111/j.1751-7117.2000.tb00211.x.

Huyen NN, Jullamate P, Kangchai W. Factors related to self-care behaviors among older adults with heart failure in Thai Nguyen General Hospital, Vietnam. Special Issue of the International Journal of the Computer, the Internet and Management. 2011;19(SP1):7.1-7.6.

Duong TV, Chang PW, Yang S-H, Chen M-C, Chao W-T, Chen T, et al. A New Comprehensive Short-form Health Literacy Survey Tool for patients in general. Asian

Nurs Res (Korean Soc Nurs Sci). 2017;11(1):30-35. doi:10.1016/j.anr.2017.02.001.

Riounin R. Health beliefs and disease control behaviors among persons with hypertension in primary care unit of Li hospital, Lamphun province [thesis]. Thailand: ChiangMai University; 2007.

Fernandez S, Chaplin W, Schoenthaler A, Ogedegbe G. Revision and validation of the Medication Adherence Self-Efficacy Scale (MASES) in hypertensive African

Americans. J Behav Med. 2008;31(6):453-462. doi:10.1007/s10865-008-9170-7.

Osborne JW. Improving your data transformations: Applying the Box-Cox transformation. Practical Assessment, Research & Evaluation. 2010;15(12):1-9

Downloads

Published

2020-07-09

How to Cite

1.
Thuy LT, Monkong S, Pookboonmee R, Leelacharas S, Viwatwongkasem C. Factors Explaining Medication Adherence of Older Adults with Hypertension: A Cross-sectional Study. PRIJNR [Internet]. 2020 Jul. 9 [cited 2024 Nov. 22];24(3):306-20. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/209539

Issue

Vol. 24 No. 3 (2020): July-September 2020

Section

Original paper

License

Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.