Abstract
Background: Adherence to antihypertensive medication is one of the key drivers of optimal blood pressure control. We found nonadherence to antihypertensive medication in some patients in the Sempaja Primary Health Care. Objective: To determine the factors that influence the patient's nonadherence to antihypertensive medication. Method: Qualitative study with in-depth interview method. Inclusion criteria are aged >18 year old, diagnosed with hypertension for at least 1 year, nonadherence to antihypertensive medication based on medical record and MMAS-8 (Morisky 8—Item Medication Adherence Questionnaire). In-depth interview was recorded, transcribed, reflected, and identified by triangulation method. Result: We have 9 subjects (67% female, 33% male), age range of 35-35 years (22.2%), 46-55 years (33.3%), >55 years (44.4%). Educational state were elementary school (44.4%), junior high school (11.1%), senior high school (44.4%). All subjects were covered by national health insurance. All subjects had blood pressure >140/90 mmhg. The pattern of antihypertensive prescribed were single oral antihypertensive (33%) and combination oral antihypertensive (67%). The identified factors are patient factors (lack of knowledge, unaware attitude, negative stigma toward primary health care), drug factors (side effect and alternative local herbal alternative), environmental factors (busy to work, wrong information from family and neighbors), healthcare system factors (difficulty in transportation, unfriendly services, low quality of education and counseling, limited drug options). Conclusion: Many factors lead to antihypertensive medication nonadherence in primary health care. We need to systematically identify the causes, optimize education and counseling, optimize prolanis program, treated hypertension with an individual approach, and invite community leaders to participate in solving existing problem.
Published Version
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