Factors Influencing Adherence to Treatment in Adult Patients with Hypertension
Authors: Chansri Petlada , Poungkaew Autchariya , Sriyuktasuth Aurawamon , Chirakarnjanakorn Srisakul 
Published: July 2024

Introduction Adherence to treatment including medication and lifestyle modification is crucial for improving health outcomes in patients with hypertension. However, there is limited research investigating the factors influencing adherence to medication and lifestyle modification, particularly among adult patients diagnosed with hypertension. 
Objective To investigate adherence to treatment and the predictive power of work status, comorbidity, complexity of medication regimens, perceived severity and risk of hypertension complications, and quality of care affecting adherence to treatment in adult patients with hypertension. 
Design Cross-sectional correlational predictive research using the multidimensional adherence model as the conceptual framework.
Methodology The sample included 156 adult patients with essential hypertension aged 18 to 59 years old who had received antihypertensive medication and lifestyle modification treatment for at least six months at a super-tertiary hospital’s hypertension clinic. Data were collected between April and July 2023. The research instruments consisted of a general profile questionnaire, a treatment adherence questionnaire for patients with hypertension, a perceived severity and risk of hypertension complications questionnaire, a patient assessment of chronic illness care, the Charlson Comorbidity Index, a medication regimen complexity index, and an illness record form. These instruments were examined for content validity by experts and tested for reliability prior to use in data collection. The reliability ranged from .77-1.00. The data were analyzed using descriptive statistics and multiple linear regression. 
Results The sample had an average age of 46.50 years (SD = 9.65); 63.46% were female. The average score for adherence to treatment was 87.97 (SD = 9.02), with the highest score for average medication adherence of 34.37 (SD = 2.52) and the lowest score for average exercise adherence of 4.33 (SD = 1.89). Additionally, 14.74% were overweight, and 71.80% were obese. The majority were employed (83.33%), without any comorbidities (62.82%), and had a low level of medication regimen complexity (68.59%). Furthermore, they demonstrated a high level of perceived severity and risk of hypertension complications (96.15%) and reported a high level of quality of care (61.54%). In the Multiple linear regression, 30.9% of the variance in adherence to treatment was explained (Adjusted R2 = .309 F(5,150) = 14.858, p < .001). Work status (β = -.262, p < .001), comorbidity (β = -.184, p = .020), perceived severity and risk of hypertension complications (β = .466, p < .001), and quality of care (β = .165, p = .017) together were significant predictors of adherence to treatment in adult patients with hypertension. 
Recommendation To promote adherence to treatment in adult patients with hypertension, nurses should develop strategy to improve quality of care within hypertension clinics and enhance the perceived severity and risk of hypertension complications as well as enhance lifestyle modifications particularly regarding diet and exercise for overweight and obese adults with hypertension.