The Association Between Multimorbidity and Medication Non-Adherence in Elderly With Hypertension in Western China

Abstract

The prevalence of hypertension increases with aging. Medication non-adherence is an important reason for the failure to control hypertension effectively, which increases the risks of cardiovascular and cerebrovascular incidents and of mortality. Multimorbidity is common among the elderly and has become a WHO-supported priority of research worldwide. While recent research suggests an association between multimorbidity and medication non-adherence, the results are not yet conclusive. The present study describes the condition of medication non-adherence and multimorbidity among a population of elderly with hypertension in western China and explores the extent of the association between multimorbidity and medication non-adherence. A cross-sectional design with multi-stage sampling was used to recruit 1,316 elderly with hypertension from nine community health centers in the cities of Chengdu, Chongqing, and Urumqi. Data were collected using the study questionnaire and analyzed using the mean, percentage, independent samples t test, Chi-square test, Kruskal-Wallis H test, and binary logistic regression. The prevalence of medication non-adherence was 28.7%, and the prevalence of multimorbidity was 77.0%. Binary logistic regression analysis found the number of comorbidities to be a predictor of antihypertensive drug non-adherence, with those elderly with three (OR = 1.742, 95% CI [1.017, 2.984], four (OR = 2.601, 95% CI [1.489, 4.544] and more than five (OR = 3.262, 95% CI [1.839, 5.788] chronic conditions at significantly higher risk of non-adherence than their peers with no comorbidities. Other associated factors included poor health behaviors (OR = 1.715, 95% CI [1.263, 2.330] and region of residence. A positive association was found between medication non-adherence and the number of comorbidities in elderly with hypertension. This suggests the need for closer monitoring of the antihypertensive-drug prescription adherence of elderly with multiple chronic conditions and for further research to explore the measures that are necessary to improve medication adherence in this population.