Adherence to Anti-hypertensive Medication among the Elderly and Associated Factors in Mandeville, Jamaica
Abstract:
Hypertension
remains a leading cause of morbidity and mortality globally, with non-adherence
to antihypertensive medication posing a significant barrier to effective
control, particularly among older adults. This study assessed adherence levels
and associated factors among geriatric hypertensive patients in Mandeville,
Jamaica. A mixed-methods design was employed. Quantitatively, a cross-sectional
survey of 220 participants aged 65 years and older was conducted using the
Morisky Medication Adherence Scale-8 (MMAS-8) and Hill-Bone Compliance Scale.
Qualitatively, in-depth interviews were held with 23 patients. Quantitative
findings showed that 61% of participants reported moderate adherence and 19%
low adherence on the MMAS-8. At the same time, the Hill-Bone scale produced an
average adherence score of 55.3 (SD = 30.1). Significant reasons for
non-adherence included lack of funds (55%), forgetfulness (19.5%), and limited
time for refills (23.2%). Significant associations were observed between
adherence and health education (χ² = 20.40, p = 0.008), possession of a
National Health Fund card (p = 0.004), physician-patient relationship (p =
0.005), and polypharmacy (χ² = 6.689, p = 0.035). Qualitative insights
underscored challenges with medication management, coping strategies, and
knowledge gaps regarding hypertension. These findings highlight the urgent need
for multifaceted interventions addressing financial, educational, and
relational factors to improve adherence and hypertension control in the
elderly.
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