Factors Influencing Medication Adherence in Hypertensive Patients

Article information

Res Community Public Health Nurs. 2010;21(1):82-91
Publication date (electronic) : 2014 April 04
doi : https://doi.org/10.12799/jkachn.2010.21.1.82
Full-time Lecturer, Department of Nursing, Jinju Health College, Korea.
Address reprint requests to: Seo, Yeong-Mi, Department of Nursing, Jinju Health College, 1142 Sangbongse-dong, Jinju 660-757, Korea. Tel: 82-10-3552-9856, Fax: 82-3030-400-1830, asfirstim@hanmail.net
Received 2010 January 18; Revised 2010 March 05; Accepted 2010 March 10.

Abstract

Purpose

The purpose of this study was to identify factors that influence medication adherence in patients with hypertension.

Methods

One hundred sixty two patients with hypertension who visited the outpatient clinics of health centers in J City participated in the study. Data were collected through a questionnaire survey done from January 9 to February 25, 2008. To analyze the sample survey data, descriptive statistics, t-test, ANOVA, Scheffe's test, and multiple regression analysis were performed with SPSS/WIN 12.0.

Results

Significant factors that affect medication adherence in patients with hypertension were autonomous motivation, competence, health status, and sex. These variables explained 24% of medication adherence (F=12.48, p<.001).

Conclusion

The results indicate that in order to improve the medication adherence of patients with hypertension it is important to develop nursing programs that focus on autonomous motivation and competence and to give consideration to differences in health status and sex. Also further studies are needed to confirm autonomous motivation related to health behavior in patients with hypertension.

References

1. Bandura A. Social foundations of thought and action: A social cognitive theory Englewood Cliffs. NJ: Prence-Hall; 1986.
2. 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.
3. Chang KO. The Relationship among health habits, perceived health status and knowledge related to hypertension and medication compliances of hypertensive elderly Busan: Busan Catolic University; 2003. Unpublished mater's thesis.
4. Deci EL, Ryan RM. Intrinsic motivation and self-determination in human behavior New York: Plenum; 1985.
5. Fawcett J. Compliance: Definition and key issue. J Clin Psychiatry 1995;56Suppl 1. :4–8. discussion 9-10.
6. Ha YC, Chun HJ, Hwang HG, Kim BS, Kim JR. The prevalence, awareness, treatment, and control of hypertension, and related factors' in rural korea. Korean J Prev Med 2000;33(4):513–520.
7. Jeon HO. Influencing factors on self-care in the elderly with essential hypertension. J Korean Acad Community Health Nurs 2008;19(1):66–75.
8. Kennedy S, Goggin K, Nollen N. Adherence to HIV medications: Utility of the theory of self-determination. Cognit Ther Res 2004;28:611–628.
9. Kim KE. A study on health behaviors and medication compliances of hypertensive patients in rural area. J Korean Community Nurs 2002;13(1):49–56.
10. Kim KW. Social welfare research methodology Seoul: MJ Media; 2008.
11. Korea Centers for Disease Control and Prevention. 2007 Korea national health statistics: The forth korea national health and nutrition examination survey (Issue Brief No. 11702) Seoul: Korea Centers for Disease Control and Prevention; 2008. 12.
12. Lee MJ. The life-style and the self-care of the patients with hypertension and diabetes in Jinhae city Busan: Inje University; 2006. Unpublished master's thesis.
13. Ministry for Health, Welfare and Family Affair. Key chronic disease management guideline. 2009 Seoul: Ministry for Health, Welfare and Family Affair; 2009.
14. Nicholas LMW. Determinants of adherence in women managing chronic health conditions New York, USA: University of Rochester; 2004. Unpublished doctoral dissertation.
15. Pellitier LG, Dion SC, Slovenic-D'Angelo M, Reid R. Why do you regulate what you eat? Relationship between forms of regulation, eating behaviors, sustained dietary behavior change, and psychological adjustment. Motiv Emot 2004;28:245–277.
16. Ryan RM, Connell JP. Perceived locus of causality and internalization: Examining reasons for acting in two domains. J Pers Soc Psychol 1989;57:749–761.
17. Sheldon KM, Williams GC, Joiner T. Selfdetermination theory in the clinic: Motivating physical and mental health New Haven, CT: Yale University Press; 2003.
18. So AY, Kim YM, Kim EY, Kim CY, Kim CH, Kim HG, et al. Effects of communuty-based case management program for clients with hypertension. J Korean Acad Nurs 2008;38(6):822–830.
19. Suh SL, Seo YM. Exercise adherence and ifluential factors in adults. J Korean Data Anal Soc 2009;11(1):199–212.
20. Sung SK. Medication adherence and the treatmentrelated factors in the patients initiating antihypertensive therapy Daejeon: Chungnam National University; 2008. Unpublished doctoral dissertation.
21. Yoo WS, Kim YK, Kim JH, Choi SK, Jeon YB. A study on the compliance of patients with essential hypertension IV. Inje Med J 1991;12(1):67–71.
22. World Health Organization. Adherence to long-term therapies. Evidence for action 2003. 01. Retrieved November 8, 2009. from http://www.who.int/chp/knowledge/publications/adherence_full_report.pdf.
23. Williams GC. Improving patients' health through supporting the autonomy of patients and providers. In : Deci EL, Ryan RM, eds. Handbook of self-determination research Rochester, NY: University Of Rochester Press; 2002. p. 233–254.
24. Williams GC, Freedman ZR, Deci EL. Supporting autonomy to motivate glucose control in patients with diabetes. Diabetes Care 1998;1:1644–1651.
25. Williams GC, Grow VM, Freedman ZR, Ryan RM, Deci EL. Motivational predictors of weight loss and weight-loss maintenance. J Pers Soc Psychol 1996;70:115–126.
26. Williams GC, McGregor HA, King D, Nelson CC, Glasgow RE. Variation in perceived competence, glycemic control, and patient satisfaction: Relationship to autonomy support from physicians. Patient Educ Couns 2005;57:39–45.
27. Williams GC, Rodin GC, Ryan RM, Grolnick WS, Deci EL. Autonomous regulation and adherence to long-term medical regimens in adult outpatients. Health Psychol 1998;17:269–276.
28. Williams GC, Patrick H, Niemiec CP, Williams LK, Devine G, Lafata JE, et al. Reducing the health risks of diabetes: How self-determination theory may help improve medication adherence and quality of life. Diabetes Educ 2009;35:484–492.
29. Zoffmann V, Lauritzen T. Guided self-determination improves life skills with Type1 diabetes and A1C in randomized controlled trial. Patient Educ Couns 2006;64:78–86.

Article information Continued

Table 1

Adherence with Therapeutic Regimen of Medication according to General Characteristics (N=162)

Table 1

Scheffe*=a<b.

Table 2

Descriptive Statistics of Study Variables (N=162)

Table 2

Table 3

Correlations among Variables

Table 3

*p<.05, **p<.01.

MA, medication adherence; AM, autonomous motivation; CM, controlled motivation; CO, competence; AS, autonomy support.

Table 4

Factors affecting Adherence with Therapeutic Regimen of Medication

Table 4