Abstract P127: Factors related to Medication Non-Adherence for Patients with Hypertension in Taiwan
Purpose: To characterize a Taiwanese population and to examine the prevalence of non-adherence to antihypertensive medications and whether cultural (e.g., use of Chinese herbs) and clinical factors (e.g., number of antihypertensive medications) were associated with non-adherence in Taiwan.
Significance: Non-adherence to antihypertensive medications is a significant clinical problem in Taiwan. However, little is known about hypertension (HTN) control and cultural and clinical factors related to non-adherence in Taiwanese.
Design: Cross-sectional study design.
Sample: A convenience sample of 200 participants were recruited from a large teaching hospital (6800 beds) in Northern Taiwan. Inclusion criteria were: Adult ≥18 years old, taking antihypertensive medications at least once daily and being able to speak Mandarin.
Methods: Following a routine medical visit, participants were consented. Study measures included seven, self-administered questionnaires on cultural and clinical factors. Blood pressure (BP) was taken twice and the averaged BP was calculated. BP control was defined as <140/90mmHg. A total score ≥80% of the highest score of medication adherence scale by Morisky’s et al. was defined as adherence.
Results: The mean age of the participants was 60.4 (±11.5 years); 62% were male. Two thirds (64.5%) had less than a high school education. The majority (86.0%) were married and lived with family or close friends (93.5%). The averaged length of HTN diagnosis was 8.6 years (±9.0 years). Medication non-adherence rate was 47.5% and uncontrolled HTN rate was 49.0%. Seventeen percent used Chinese herbs for treating their disease (e.g., cough) and promoting health in addition to their regular antihypertensive medications. Statistically significant factors associated with medication non-adherence were: (1) Lower Perceived Susceptibility to HTN-related complications [OR=1.15 (95% CI 1.01, 1.31)]; and (2) Longer Length of HTN Diagnosis [OR=1.06 (95%CI 1.01, 1.12)].
Conclusions: Non-adherence medication rates were, 47.5%, in the Taiwanese compared to only 20% for US population. In turn, inadequate HTN control was 49% for Taiwanese and 30% for the general US population. Taiwanese who are at risk for non-adherence are those individuals who perceived a lower susceptibility to HTN-related complications or had a longer (in years) diagnosis of HTN. Further studies are needed to identify the influence of herbs on adherence behavior.
Implications: These findings indicate that culturally sensitive and clinically appropriate nursing interventions for HTN management in Taiwanese are essential if non-adherence to the antihypertensive medications is to be managed.
- © 2012 by American Heart Association, Inc.