Determinants of Medication Adherence to Antihypertensive Medications among a Chinese Population Using Morisky Medication Adherence Scale

Abstract

Background and ObjectivesPoor adherence to medications is one of the major public health challenges. Only one-third of the population reported successful control of blood pressure, mostly caused by poor drug adherence. However, there are relatively few reports studying the adherence levels and their associated factors among Chinese patients. This study aimed to study the adherence profiles and the factors associated with antihypertensive drug adherence among Chinese patients.MethodsA cross-sectional study was conducted in an outpatient clinic located in the New Territories Region of Hong Kong. Adult patients who were currently taking at least one antihypertensive drug were invited to complete a self-administered questionnaire, consisting of basic socio-demographic profile, self-perceived health status, and self-reported medication adherence. The outcome measure was the Morisky Medication Adherence Scale (MMAS-8). Good adherence was defined as MMAS scores greater than 6 points (out of a total score of 8 points).ResultsFrom 1114 patients, 725 (65.1%) had good adherence to antihypertensive agents. Binary logistic regression analysis was conducted. Younger age, shorter duration of antihypertensive agents used, job status being employed, and poor or very poor self-perceived health status were negatively associated with drug adherence.ConclusionThis study reported a high proportion of poor medication adherence among hypertensive subjects. Patients with factors associated with poor adherence should be more closely monitored to optimize their drug taking behavior.

Non-Adherence to Antihypertensive Drugs: A Systematic Review and Meta-Analysis

“…Finally, 28 articles were included in the systematic review and 25 of these were included in the meta-analysis. [9,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][27][28][29][30][31][33][34][35][36] …”

“…Nine of the studies were conducted in the United States, [11,12,15,26,29,30,32,33,35] and 2 each in China, [11,17] Nigeria, [16,22] Hong Kong, [21,25] and Iran. [10,18] Countries such as Uganda, Lebanon, Kenya, Republic of Korea, Peru, Ethiopia, Ghana, Malaysia, Palestine, Brazil, and Italy were represented with a single study.…”

“…[9,13,19,20,23,24,27,28,31,34,36] These studies were conducted on hypertensive patients to assess medication adherence using MMAS-8 between January 2009 and March 2016. Twenty-four studies were cross-sectional [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] and others were cohort, [35] observational, [36] and interventional studies. [32] Only 1 randomized controlled trial (RCT) was found.…”

“…[29] The sample size of studies ranged from 25 [32] to 2445 [21] subjects. Eleven studies assessed adherence through face-to-face interviews, [10,14,18,20,[22][23][24]26,[29][30][31] while 8 studies used selfadministered questionnaires, [13,17,21,25,[32][33][34]36] and only 1 study was administered through a telephone interview. [35] However, 8 studies did not specify the type of MMAS-8 questionnaire administered.…”

Compliance with adjuvant capecitabine in patients with stage II and III colon cancer: comparison of administrative versus medical record data

“…While oral agents pose many notable advantages when compared to conventional parenteral drugs, including enhanced convenience of self‐administration, reduced hospital and societal costs, and improved patient engagement in their own care 1, 2, 3, 4, these benefits must be balanced against growing concerns regarding poor compliance to treatment and its potentially negative impact on outcomes 1, 2, 3, 4, 5, 6. Suboptimal adherence to medications is a commonly recognized problem for many chronic medical conditions, such as hypertension and diabetes mellitus, where it has been shown to compromise drug effectiveness 7, 8, 9, 10.…”