Abstract
Background: Studies have reported that medication literacy had a positive effect on medication adherence in patients with hypertension. However, little is known about the mechanism underlying this relationship in patients with hypertension. Objective: The purpose of this study was to investigate the mediating effect of self-efficacy between medication literacy and medication adherence. Methods: A total of 790 patients with hypertension were investigated using the Chinese Medication Literacy Scale for Hypertensive Patients (C-MLSHP), the Morisky Medication Adherence Scale-8 (MMAS-8) and the Medication Adherence Self-efficacy Scale-Revision (MASES-R). Hierarchical regression and the bootstrap approach were used to analyze the mediating effect of self-efficacy on the relationship between medication literacy and medication adherence. Results: A total of 60.9% of hypertensive patients were low adherent to their antihypertensive drug regimens. Self‐efficacy had a significant positive correlation with medication literacy (r= 0.408, p < 0.001) and medication adherence (r = 0.591, p < 0.001). Self-efficacy accounts for 28.7% of the total mediating effect on the relationship between medication literacy and adherence to antihypertensive regimens for hypertensive patients. Conclusion: More than half of the hypertensive patients in the study were low adherent to antihypertensive regimens. Self-efficacy had a partial significant mediating effect on the relationship between medication literacy and medication adherence. Therefore, it was suggested that hypertensive patients’ medication adherence might be improved and driven by increasing self-efficacy. Targeted interventions to improve patients’ self-efficacy should be developed and implemented. In addition, health care providers should also be aware of the importance of medication literacy assessment and promotion in patients with hypertension.
Highlights
Hypertension has caused great damage to human health and consumed a large amount of medical resources worldwide, it is a leading problem in global public health management and promotion (Irazola et al, 2016)
Poor blood pressure control can eventually lead to various complications and comorbidities, such as heart diseases, stroke and kidney failure, as well as increasing premature mortality and disability, which has contributed to high costs in dealing with these medical outcomes (World Health Organization, 2013)
Patients’ poor adherence to antihypertensive regimens is a prevalent problem that has limited the efficacy of antihypertensive drugs and leads to suboptimal blood pressure control (Abegaz et al, 2017; Hamdidouche et al, 2017)
Summary
Hypertension has caused great damage to human health and consumed a large amount of medical resources worldwide, it is a leading problem in global public health management and promotion (Irazola et al, 2016). A review analyzed 24 studies and found that approximately 31% of cases of resistant hypertension may be attributed to poor adherence to the medication regimens (Hamdidouche et al, 2017). Another meta-analysis of 28 studies showed that among 12,603 hypertensive patients, 45.2% were nonadherent to antihypertensive medication, and 83.7% of patients with nonadherence were found to have uncontrolled blood pressure (Abegaz et al, 2017). Little is known about the mechanism underlying this relationship in patients with hypertension
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