Analysis of Medication Adherence Level and Influencing Factors in Hypertension Patients in Samarinda City

Sinta Ratna Dewi, Almahdy Almahdy, Hardisman Dasman, Syofyan Syofyan, Aldyba Syaqilla Hafifah

Abstract


Hypertension is a degenerative condition that significantly contributes to global morbidity and mortality, making medication adherence a critical factor in achieving long-term therapeutic success. This study investigates the relationship between patient-related factors and adherence to antihypertensive medication. A cross-sectional analytical survey was conducted among 195 hypertensive patients in Samarinda, East Kalimantan. Data were collected using a structured questionnaire incorporating the MMAS-8 scale, which categorizes adherence into high (score = 8), moderate (score = 6–7), and low (score < 6), alongside a validated instrument assessing sociodemographic, clinical, and behavioral determinants. Statistical analysis employed chi-square tests and odds ratios (OR) with 95% confidence intervals. The majority of patients demonstrated low adherence (65.6%), followed by moderate (28.7%) and high adherence (5.6%). Significant associations were found between adherence levels and gender (P = 0.033, OR = 0.513, 95% CI: 0.276–0.951), knowledge level (P = 0.013, OR = 2.190, 95% CI: 1.176–4.079), duration of hypertension (P = 0.017, OR = 0.483, 95% CI: 0.265–0.881), and insurance status (P = 0.004, OR = 0.080, 95% CI: 0.009–0.680). Knowledge level emerged as the most influential factor in promoting adherence. These findings highlight the importance of targeted educational interventions and sustained support for patients at risk of poor adherence, aiming to optimize antihypertensive therapy and prevent long-term complications. The study advocates for strengthened evidence-based clinical practices and underscores the need for health policy reforms particularly in patient education and insurance accessibility to improve hypertension management in primary care settings.

 

Keyword: Adherence, Hypertension, Gender, Knowledge

Full Text:

PDF

References


Al-Noumani, H., Al-Harrasi, M., Jose, J., Al-Naamani, Z., & Panchatcharam, S. M. (2022). Medication Adherence and Patients’ Characteristics in Chronic Diseases: A National Multi-Center Study. Clin Nurs Res., 31(3), 426–434. https://doi.org/10.1177/10547738211033754

ALruwaili, B. F. (2024). Evaluation of Hypertension-Related Knowledge, Medication Adherence, and Associated Factors Among Hypertensive Patients in the Aljouf Region, Saudi Arabia: A Cross-Sectional Study. Medicina (Kaunas, Lithuania), 60(11). https://doi.org/10.3390/medicina60111822

Badan Kebijakan Pembangunan Kesehatan. (2023). Survei Kesehatan Indonesia (SKI). In KEMENKES.

Cahyadi, R. I., Wijono, C. O., Adithia, F. K., Rupini, N.L.S., Sani’ah, Sincihu, Y., et al. (2024). Gambaran Kepatuhan Minum Obat Penderita Hipertensi Dusun Sumberame, Kecamatan Wringinanom. Communnity Development Journal, 5(2), 3591–3597.

Choudhry, N. K., Kronish, I. K., Vongpatanasin, W., Ferdinand, K. C., Pavlik, V. N., Egan, B. M., et al. (2021). Medication Adherence and Blood Pressure Control: A Scientific Statement From the American Heart Association. Hypertension, 79(1), 1–14. https://doi.org/doi/10.1161/HYP.0000000000000203

Das, B., Neupane, D., Singh Gill, S., & Bir Singh, G. (2021). Factors affecting non-adherence to medical appointments among patients with hypertension at public health facilities in Punjab, India. Journal of Clinical Hypertension, 23(4), 713–719. https://doi.org/10.1111/jch.14142

Dinas Kesehatan Kalimantan Timur. (2023). Data Angka Kesakitan Prov. Kaltim Tahun 2021-2023.

Gemeda, A. T., Regassa, L. D., Weldesenbet, A. B., Merga, B. T., Legesse, N., & Tusa, B. S. (2020). Adherence to antihypertensive medications and associated factors among hypertensive patients in Ethiopia: Systematic review and meta-analysis. SAGE Open Medicine, 8, 1–22. https://doi.org/10.1177/2050312120982459

Gumilas, N. S. A., Harini, I. M., Samodro, P., & Ernawati, D. A. (2021). Mmas-8 score assessment of therapy adherence to glycemic control of patients with type 2 diabetes mellitus, Tanjung Purwokerto, Java, Indonesia (October 2018). Southeast Asian Journal of Tropical Medicine and Public Health, 52(3), 359–370.

Hamtaeigashti, S., Shamsi, M., Sahraian, M. A., Soltani, R., & Almasi-Hashiani, A. (2023). Effect of an educational intervention based on the theory of planned behavior on improving medication adherence in patients with multiple sclerosis treated with injectable disease-modifying drugs: randomized controlled trial. BMC Public Health, 23(1), 1–13. https://doi.org/10.1186/s12889-023-15910-6

Husnawati, Sukandar, E. Y., & Anggadiredja, K. (2022). Medication Adherence and Characteristics of Hypertensive Patients: A Study in Rural Areas. Research Journal of Pharmacy and Technology, 15(1), 370–374. https://doi.org/10.52711/0974-360X.2022.00060

Joho, A. A. (2021). Using the Health Belief Model to Explain the Patient ’ s Compliance to Anti-hypertensive Treatment in Three District Hospitals - Dar. East African Journal of Public Health, 5(1), 50–58.

Joo, H. J., Yum, Y., Kim, Y. H., Son, J. W., Kim, S. H., Choi, S., Han, S., Shin, M. S., Jeong, J. O., & Kim, E. J. (2023). Gender Difference of Blood Pressure Control Rate and Clinical Prognosis in Patients With Resistant Hypertension: Real-World Observation Study. Journal of Korean Medical Science, 38(16), 1–12. https://doi.org/10.3346/JKMS.2023.38.E124

Kementerian Kesehatan Republik Indonesia. (2022). Profil kesehatan indonesia 2022.

Kim, H. J., Kim, B. S., Kim, H., Lee, J., Shin, J. H., & Sung, K. C. (2025). Impact of blood pressure and medication adherence on clinical outcomes in patients with hypertension. Frontiers in Medicine, 12(Mi). https://doi.org/10.3389/fmed.2025.1564791

Kishor, R., Kumari, S., Prakash, R., Chaudhary, N., Shyama, S., Ahmad, S., & Kumar, P. (2024). An assessment of treatment compliance using the Morisky scale‑8 tool in adult hypertensive patients of Eastern India. Journal of Family Medicine and Primary Care, 13(3), 924–931. https://doi.org/10.4103/jfmpc.jfmpc

Konlan, K. D., Konlan, K. D., Abdulai, J. A., Saah, J. A., Doat, A. R., Amoah, R. M., & Mohammed, I. (2023). The relationship between trust, belief and adherence among patients who complain of hypertension in Ghana. Nursing Open, 10(9), 6205–6214. https://doi.org/10.1002/nop2.1855

Mahmood, S., Jalal, Z., Hadi, M. A., Orooj, H., & Shah, K. U. (2020). Non-adherence to prescribed antihypertensives in primary, secondary and tertiary healthcare settings in Islamabad, Pakistan: A cross-sectional study. Patient Preference and Adherence, 14, 73–85. https://doi.org/10.2147/PPA.S235517

Mentari, W. D., Dwidaningrum, F., Rizki, J. R. N., & Mentari, M. P. (2024). Faktor determinan kepatuhan pasien dalam pengobatan hipertensi. 4(02), 283–290. Retrieved from https://doi.org/10.34305/jhrs.v4i2.1389

Morisky, D. E., Ang, A., Krousel‐Wood, M., & Ward, H. J. (2023). Retraction Statement: Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich), 25(9), 889. https://doi.org/doi: 10.1111/jch.14718

Nili, M., Mohamed, R., & Kelly, K. M. (2020). A systematic review of interventions using health behavioral theories to improve medication adherence among patients with hypertension. Translational Behavioral Medicine, 10(5), 1177–1186. Retrieved from https://doi.org/10.1093/tbm/ibaa020

Oktamianti, P., Kusuma, D., Amir, V., Tjandrarini, D. H., & Paramita, A. (2022). District-Level Inequalities in Hypertension among Adults in Indonesia: A Cross-Sectional Analysis by Sex and Age Group. International Journal of Environmental Research and Public Health, 19(20). https://doi.org/10.3390/ijerph192013268

Paczkowska, A., Hoffmann, K., Kus, K., Kopciuch, D., Zaprutko, T., Ratajczak, P., et al. (2021). Impact of patient knowledge on hypertension treatment adherence and efficacy: A single-centre study in Poland. International Journal of Medical Sciences, 18(3), 852–860. https://doi.org/10.7150/ijms.48139

Rhamttallah, M., Mahmoud, A., Mohamedelnour, E., Magzoub, H., & Altayib, L. S. (2025). Impact of hypertension knowledge on adherence to antihypertensive therapy: a cross-sectional study in primary health care centers during the 2024 Sudan conflict. BMC Primary Care, 26(1). https://doi.org/10.1186/s12875-025-02812-2

Świątoniowska-Lonc, N., Polański, J., Mazur, G., & Jankowska-Polańska, B. (2021). Impact of beliefs about medicines on the level of intentional non-adherence to the recommendations of elderly patients with hypertension. International Journal of Environmental Research and Public Health, 18(6), 1–11. https://doi.org/10.3390/ijerph18062825

Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., et al. (2020). 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension, 75(6), 1334–1357. https://doi.org/https://doi.org/10.1161/HYPERTENSIONAHA.120.15026

Venditti, V., Bleve, E., Morano, S., & Filardi, T. (2023). Gender-Related Factors in Medication Adherence for Metabolic and Cardiovascular Health. Metabolites, 13(10), 1087. https://doi.org/10.3390/metabo13101087

WHO. (2024). Hypertension. Retrieved May 3, 2024, from https://www.who.int/health-topics/hypertension#tab=tab_1

Yusransyah, Halimah, E., & Suwantika, A. A. (2020). Measurement of the quality of life of prolanis hypertension patients in sixteen primary healthcare centers in Pandeglang District, Banten Province, Indonesia, using EQ-5D-5L instrument. Patient Preference and Adherence, 14, 1103–1109. https://doi.org/10.2147/PPA.S249085

Zhou, X., Zhang, X., Gu, N., Cai, W., & Feng, J. (2024). Barriers and Facilitators of Medication Adherence in Hypertension Patients: A Meta-Integration of Qualitative Research. Journal of Patient Experience, 11, 1–17. https://doi.org/10.1177/23743735241241176




DOI: http://dx.doi.org/10.30829/contagion.v7i2.24419

Refbacks

  • There are currently no refbacks.


Copyright (c) 2025 Sinta Ratna Dewi, Almahdy Almahdy, Hardisman Dasman, Syofyan Syofyan, Aldyba Syaqilla Hafifah

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

 
Contagion: Scientific Periodical Journal of Public Health and Coastal Health by Program Studi Ilmu Kesehatan Masyarakat is licensed under Creative Commons Attribution-ShareAlike 4.0 International License.