The Influence of Sociodemographic Factors and Disease Characteristics on the Medication Adherence among Hypertensive Patients
Abstract
Hypertension is a major global public health concern associated with increased risk of cardiovascular morbidity and mortality. Despite the availability of effective antihypertensive therapy, suboptimal blood pressure control remains prevalent, particularly in low- and middle-income countries. Poor medication adherence is a key contributing factor, often influenced by various sociodemographic and clinical characteristics. This study aimed to assess the level of medication adherence among hypertensive patients and to examine the association between sociodemographic and clinical factors and adherence behavior in an urban Indonesian population. A cross-sectional study was conducted among 153 hypertensive patients attending six public health centers in Medan City, Indonesia, between August and October 2021. Participants were selected using purposive sampling. Medication adherence was assessed using the validated Indonesian version of the Eight-Item Morisky Medication Adherence Scale (MMAS-8). Data on age, education, income, family history, body mass index, comorbidities, and blood pressure were collected through interviews and direct measurements. Bivariate and multivariate logistic regression analyses were performed using SPSS version 24.0 to identify significant predictors of adherence. Among the participants, 52.3% demonstrated high medication adherence, while 47.7% had low adherence. Multivariate analysis revealed that age ≥45 years (RP = 4.29; p = 0.023), low education level (RP = 1.50; p = 0.044), and family history of hypertension (RP = 2.05; p = 0.040) were significantly associated with adherence. Other variables, including income, BMI, and comorbidities, were not significant predictors. Medication adherence among hypertensive patients remains suboptimal. Targeted interventions focusing on older adults, patients with lower education, and family-centered support may enhance adherence and improve hypertension management outcomes.
Keywords: Adherence, Education, Hypertension, Risk factors
Full Text:
PDFReferences
Akbar, P. S., Parinduri, S. K., & Hidana, R. (2019). Gambaran Pelaksanaan Surveilans Epidemiologi Di Rumah Sakit Umum Daerah Leuwiliang Kabupaten Bogor Tahun 2018. Promotor, 2(5), 410–421. https://doi.org/DOI: http://dx.doi.org/10.32832/pro.v2i5.2529
Algabbani, F. M. (2020). Treatment adherence among patients with hypertension: findings from a cross-sectional study. Clin Hypertens, 26(18), 1–10. https://doi.org/10.1186/s40885-020-00151-1
Allender. (2014). Community Health Nursing Promoting The Public’s Health (8th Edditi). Lippincott Williams & Wilkins.
Amaliah, F. (2014). Faktor Risiko Hipertensi Pada Orang Umur 45-74 Tahun Di Pulau Sulawesi. Gizi Indonesia, 37(2), 145-151. https://doi.org/10.36457/gizindo.v37i2.160
Anteneh, Z. A. (2015). Prevalence and correlation of hypertension among adult population in Bahir Dar city, northwest Ethiopia: a community based cross-sectional study. International Journal of General Medicine, 8(1), 175–185. https://doi.org/10.2147/IJGM.S81513
Aynalem, G. A. (2021). Factors affecting adherence to lifestyle modification among patients with hypertension at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, 2019. SAGE Open Medicine, 9(1), 1–10. https://doi.org/10.1177/20503121211012523
Banjarnahor, R. O. (2023). Path Analysis on the Effect of Stress, Sleep Quality, and Hypertension on Type 2 Diabetes Mellitus Incidence in the 30–60 years Age Group in Medan City. Contagion: Scientific Periodical Journal of Public Health and Coastal Health, 5(4), 1169-1183. https://doi.org/10.30829/contagion.v5i4.17688
Choudhry, N. K. (2022). Medication adherence and blood pressure control: A scientific statement from the american heart association. Hypertension, 79(1), E1–E14. https://doi.org/10.1161/HYP.0000000000000203
Garwahusada, E. (2020). Hubungan Jenis Kelamin, Perilaku Merokok, Aktivitas Fisik Dengan Hipertensi Pada Pegawai Kantor. Media Gizi Indonesia, 15(1), 60-65. https://doi.org/10.204736/mgi.v15i1.60–65
Giakoumidakis, K. (2024). Patient Knowledge, Medication Adherence, and Influencing Factors: A Cross-Sectional Study among Hypertensive Patients in Greece. Healthcare, 12(9), 916. https://doi.org/10.3390/healthcare12090916
Gusty, R. (2022). Association between Knowledge and Self-care Adherence among Elderly Hypertensive Patient in Dwelling Community. Open Access Macedonian Journal of Medical Sciences, 10(1), 206–212. https://doi.org/10.3889/oamjms.2022.8342
Herziana. (2017). Faktor Resiko Kejadian Penyakit Hipertensi Di Puskesmas Basuki Rahmat Palembang. Jurnal Unja, 1(1), 31–39.
Insani, W. N. (2025). Exploring the association of adverse drug reactions with medication adherence and quality of life among hypertensive patients: a cross-sectional study. International Journal of Clinical Pharmacy, 47(2), 354–364. https://doi.org/10.1007/s11096-024-01832-9
Ishida, T. (2019). Treatment patterns and adherence to antihypertensive combination therapies in Japan using a claims database. Hypertension Research, 42(2), 249–256. https://doi.org/10.1038/s41440-018-0127-0
Lee, H. (2021). Adherence to Antihypertensive Medication and Incident Cardiovascular Events in Young Adults with Hypertension. Hypertension, 77(4), 1341–1349. https://doi.org/10.1161/Hypertensionaha.120.16784
Nishimura, S. (2020). Adherence to antihypertensive medication and its predictors among non-elderly adults in Japan. Hypertension Research, 43(7), 705–714. https://doi.org/10.1038/s41440-020-0440-2
Poulter, N. R. (2020). Medication adherence in hypertension. Journal of Hypertension, 38(4), 579–587. https://doi.org/10.1097/HJH.0000000000002294
Pramiastuti, O. (2020). Manajemen Diri Untuk Pencegahan Penyakit Diabetes Melitus dan Hipertensi Masyarakat Desa Mangunsaren Melalui Produk Minuman Tanaman Herbal. JABI: Jurnal Abdimas Bhakti Indonesia, 1(2), 1–10. https://doi.org/https://doi.org/10.36308/jabi.v1i2.214
Sagara, K. (2024). Medication adherence and associated factors in newly diagnosed hypertensive patients in Japan: the LIFE study. Journal of Hypertension, 42(4), 718–726. https://doi.org/10.1097/HJH.0000000000003661
Sartik, R. (2017). Faktor – Faktor Risiko Dan Angka Kejadian Hipertensi Pada Penduduk Palembang. Jurnal Ilmu Kesehatan Masyarakat, 8(3), 180–191. https://doi.org/10.26553/jikm.2017.8.3
Sastroasmoro, S. (2017). Dasar-Dasar Metodologi Penelitian Klinis (Edisi Ke-5). Sagung Seto.
Siregar, P. A. (2020). Aktivitas Fisik, Konsumsi Makanan Asin dan Kejadian Hipertensi Masyarakat Pesisir Kota Medan. Jurnal Ilmiah Kesehatan (JIKA), 2(1), 1–8. https://doi.org/doi.org/10.36590/jika.v2il.34
Susanti, N. (2020). Sensitivitas Dan Spesifisitas Titik Potong RLPTB Sebagai Prediktor Kejadian Hipertensi Pada Orang Dewasa di Dusun Sido Waras Desa Kwala Begumit. Contagion : Scientific Periodical of Public Health and Coastal Health, 2(2), 65–75. https://doi.org/10.30829/contagion.v2i2.7083
Tarigan, A. R. (2021). Analysis of Family Support and Diet Compliance in Hypertension Patients. Contagion : Scientific Periodical of Public Health and Coastal Health, 3(1), 16–28. https://doi.org/10.30829/contagion.v3i1.9123
Ullah, S. (2023). Use and outcomes of antihypertensive medication treatment in the US hypertensive population: A gender comparison. Health Promotion Perspectives, 13(2), 140–146. https://doi.org/10.34172/hpp.2023.17
Umemura. (2019). The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019). Hypertension Research, 42(9), 1235-1481. https://doi.org/10.1038/s41440-019-0284-9
Wakai, E. (2021). Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension. PLoS ONE, 16(6), e0252944. https://doi.org/10.1371/journal.pone.0252944
DOI: http://dx.doi.org/10.30829/contagion.v7i1.23198
Refbacks
- There are currently no refbacks.
Copyright (c) 2025 Fazidah Aguslina Siregar, Asfriyati Asfriyati
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
