SELF-CARE MANAGEMENT AMONG ELDERLY PATIENTS WITH HYPERTENSION AND POOR ADHERENCE TO TREATMENT, LIVING IN RURAL THAILAND: A QUALITATIVE STUDY

Abstract

Background: Hypertension is a common health problem among the elderly. Approximately 50% have poor adherence to their prescribed medication, which leads to uncontrolled blood pressure. This study was aimed to understand causes of poor adherence and gain knowledge of patient's self-management in their home. Methods: In-depth interviews were conducted. Elderly hypertension patients with poor adherence to antihypertension medication and uncontrol blood pressure, between the ages of 60-79 were purposively selected to participate in this study. Home visits, including observation of patient's behavior in their home, were conducted. Content analysis was performed. Results: A total of thirty respondents were interviewed of which 17 were female and 13 were male. All understood that hypertension is a chronic health problem but most of them were unaware that nonadherence to their hypertension medication treatment would lead to negative consequence to their health. Most respondents had negative beliefs toward hypertension treatment. The reasons for poor adherence are: 1) personal beliefs or habits, which include forgetfulness and negative belief that the medication will not control blood pressure; 2) side effects of medication and 3) negative perceptions influenced by the community. Research results showed that most participants were not taking their prescribed dosage. Additionally, expired medication was commonly found in their medication inventory. High sodium diets and no regular exercise was commonly reported. Conclusion: Patients understood that hypertension is a lifelong condition but unaware of consequence of poor adherence. Personal reason and negative belief as well as wrong belief influenced by community. Forgetfulness and manage dosage of medication should be addressed when designing a strategy to improve medical adherence. Education on controlling hypertension and treatments should be addressed and incorporated into a holistic strategy to improve adherence to the patient's drug regimen.