Beliefs about medicine and medication adherence among hypertensive patients in the community setting

Abstract

The aim of this study was to evaluate the medication adherence, quality use of medicine, beliefs about medicines and the inter-relationships with blood pressure (BP) control among hypertensive patients at the community level in the state of Penang, Malaysia. A cross-sectional survey with onsite clinical measurement was conducted in the state of Penang, Malaysia from August 2015 to April 2016. All hypertensive patients completed a series of validated questionnaires, including the Beliefs about Medicines Questionnaire (BMQ), 8-item Malaysian Medication Adherence Scale (MALMAS) and patient-related factors in quality use of medicine. A total of 384 patients participated in the study. The mean age of patients was 56.8 ± 12.6 years and mean BP level was 144/87 ± 21/15 mmHg. More than half (57.8%) of the patients were non-adherent to their medications and non-adherent patients had significantly (p ≤ 0.022) higher systolic blood pressure (SBP) and diastolic pressure (DBP) than adherent patients. A significant association was found between sharing of medication (p = 0.001), knowledge of the targeted BP level (p = 0.004), person with whom the antihypertensive medication will be discussed (p = 0.004) and medication adherence. According to a logistic regression analysis, factors such as unemployment, longer duration of hypertension, higher perceived medication needs, lower belief in medication harmfulness and higher score in necessity-concerns differential were associated with a higher adherence rate to antihypertensive medication. The medication adherence level was considered low among hypertensive patients at the community level and the low adherence level was significantly associated with higher mean BP level. This study demonstrated the importance of patients’ beliefs regarding the necessity of and concerns about medication and their association with medication adherence, with sharing medication being strongly associated with poor medication adherence. The findings from this study could be useful for planning strategies to improve adherence among community dwelling hypertensive patients in Malaysia.