Factors Influencing Medication Adherence in Elderly Patients with Hypertension: A Single Center Study in Western China

Figures & data

Figure 1 Theoretical model of factors influencing medication adherence behavior. The conceptual model combined the strongest components of the Theory of Planned Behavior (TPB) and the Health Belief Model (HBM).

Table 1 Psychometric Assessment of Part 3 of the Questionnaire (N=400)

Variable	Choice	Factor	KMO	Cronbach’s α
Perceived Susceptibility	If I do not comply with my medication, my blood pressure cannot be effectively controlled.	0.871	0.738	0.867
	Not complying with my medication will increase the risk of hypertension and its complications such as stroke, coronary heart disease and kidney disease.	0.857
	There are people who have suffered from hypertension and its complications due to nonadherence with medication.	0.867
Perceived Severity	I only take medication when I am not feeling well.	0.872	0.734	0.870
	I decide whether to stop taking my medication or not.	0.856
	Whether I take my medication depends on my blood pressure. I do not have to follow my doctor’s recommendations	0.870
Perceived Barriers	I have a poor memory. Sometimes I forget to take my medication.	0.884	0.748	0.892
	I am sometimes too busy to take medication.	0.908
	Sometimes my blood pressure is well controlled and I stop taking medication to save on medical expenses.	0.885
Perceived Benefits	Blood pressure is well controlled as long as I take medication every day.	0.876	0.742	0.876
	The risk of hypertension and its complications such as stroke, coronary heart disease and kidney disease can be effectively reduced as long as medication is taken daily in adherence with my doctor.	0.881
	As long as my medication is taken daily, it can significantly improve quality of life for my family.	0.834
Behavioral Attitudes	If my blood pressure is not controlled properly, it has adverse effects on health.	0.901	0.759	0.914
	If my blood pressure is not under control, it will affect normal work and daily life.	0.894
	If my blood pressure is not under control, it will increase the risk of complications such as stroke, coronary heart disease and kidney disease, and increase the burden on the family.	0.869
Behavioral Intention	What is your overall willingness to take medication?	0.901	0.759	0.925
	Do you take your medication in order to promote health?	0.894
	Will you actively take medication in the future?	0.869
Medication Adherence Behavior	I have been taking medication in the exact dosage and frequency recommended by the doctor in the past 6 months.	0.916	0.770	0.938
	I do not stop taking medication on my own even when I feel that my condition is under control.	0.915
	I do not change the dosage and frequency of medication when I feel that my condition has worsened.	0.909
Overall			0.822	0.849

Table 2 Patient Demographic Characteristics (N=400)

Characteristic	Categories	n	%
Gender
	Male	196	49.00%
	Female	204	51.00%
Age
	60~65	163	40.75%
	66~70	159	39.75%
	71~75	56	14.00%
	76~80	19	4.75%
	>80	3	0.75%
Education
	Below high school	192	48.00%
	High school	125	31.25%
	Higher education	53	13.25%
	Other	30	7.50%
Marital status
	Married	183	45.75%
	Single	9	2.25%
	Divorced/widowed	208	52.00%
Occupation
	Farmer	218	54.50%
	Public officials	68	17.00%
	Enterprise personnel	45	11.25%
	Self-employed person	18	4.50%
	Other	51	12.75%
Monthly income
	<1500 Yuan	69	17.25%
	1500–3000 Yuan	136	34.00%
	3001–4500 Yuan	121	30.25%
	>4500 Yuan	74	18.50%
Social security
	Employee medical insurance	109	27.25%
	Resident medical insurance	72	18.00%
	Other	219	54.75%
Course of disease
	≤5 years	36	9.00%
	6–10 years	217	54.25%
	11–15 years	89	22.25%
	>15 years	58	14.50%

Figure 2 Path analysis medication adherence behavior. In structural equation modeling, the p-value is used to determine the significance of the assumed path. Model output results indicate that the independent variable is significantly correlated with the dependent variable at the 0.01 or 0.001 level.

Notes: **P value <0.01; ***P value <0.001.