Abstract
Socioeconomic impacts on adherence are understudied, particularly in disadvantaged areas. This study aimed to evaluate socioeconomic factors on medication adherence among patients with hypertension in Lombok, Indonesia. A cross-sectional survey was conducted in all six public hospital outpatient clinics in Lombok in 2017. Data was obtained using a validated questionnaire to which the Morisky Green Levine Adherence Scale (MGLS) questionnaire was used to assess medication adherence. Binary logistic regression was performed to determine independent socioeconomic associations. A total of 693 patients with hypertension were included (response rate 84%). The majority had low adherence (76.2%). Significant independent associations were reported between setting and education with adherence (rural versus urban setting: odds ratio 3.54, p<0.001; primary versus university level education: odds ratio 5.39, p<0.001). Socioeconomic associations provide some basis for the development of patient and population-based interventions to improve adherence among patients with hypertension in Indonesia, particularly in disadvantaged areas.
Highlights
Indonesia is the largest archipelagic country and one of the most populous in the world, with more than 250 million people (MoH-RI 2014)
More female patients with hypertension volunteered than males, in all settings
The majority of participants were in the age group of >50 years (74.5%),and were diagnosed with hypertension between 1 to 5 years or more than 10 years (48.5% versus 26.6%, respectively)
Summary
Indonesia is the largest archipelagic country and one of the most populous in the world, with more than 250 million people (MoH-RI 2014). The burden of cardiovascular diseases (CVD) in Indonesia have increased significantly, with stroke and coronary heart diseases being ranked the first and second leading causes of death in 2014 (21.1% and 12.9%, respectively) (MoH-RI 2014). Based on the data from Basic Health Research, the prevalence of hypertension among adults aged ≥18 years in Indonesia had risen from 25.8% or 42.1 million in 2013 to 34.1% of the population in 2018 (MoH-RI 2013; MoH-RI 2019a). This has resulted in increased cost of hypertension related services each year, with expenditures of 2.8 trillion Indonesian Rupiah (IDR) in 2017 to 3 trillion IDR in 2018 (MoH-RI 2019a). The Indonesian Government has included hypertension management as one of the national health indicators (RoI 2015)
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