Socioeconomic impacts on medication adherence among patients with hypertension: A multicentre cross-sectional study in Lombok, Indonesia

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.

Medication adherence and blood pressure control: A preliminary assessment of the role of health insurance in Nigeria and Ghana

“…Low income was also found to be associated with poor medication adherence among hypertensive patients in Indonesia and Panam. 15 , 28 Non medication adherence leads to increased morbidity and mortality and poor outcome. Efforts should therefore be made to increase medication adherence by increasing accessibility to medications.…”

“…Participants with blood pressure <140/90 mmHg were classified as controlled while those with BP ⩾ 140/90 mmHg were classified as uncontrolled. 15 , 21 , 22…”

“…Participants with blood pressure <140/90 mmHg were classified as controlled while those with BP ⩾ 140/90 mmHg were classified as uncontrolled. 15,21,22 Medication adherence was assessed using the Hill Bone Scale which has been validated for use in blacks. 23,24 The 9-item medication subscale of the 14-item tool was used to assess for medication adherence in the respondents.…”

“… 9 , 10 , 13 A study in Indonesia found a significant association between low socioeconomic status and medication adherence among patients with hypertension, as a good number of patients stop their medications because they could not afford them. 15 Other studies in Nigeria, Ghana and Tanzania also highlighted the role of poverty in patients’ adherence to medications and blood pressure control. 16 – 18 Patients might then typically resort to alternative medicines, self-prescriptions or outright stoppage of the medications.…”

Knowing the gap: medication use, adherence and blood pressure control among patients with hypertension in Indonesian primary care settings

“…, hydrochlorothiazide) ( Ministry of Health Republic of Indonesia, 2013 ). Locally based small studies in Indonesian primary care settings have explored drug therapy and adherence among patients with hypertension reporting low levels of medication adherence, ranging from 20–59% ( Liberty, Pariyana & Roflin, 2017 ; Sinuraya et al, 2018 ; Setiadi et al, 2021 ; Rahmadani & Sari, 2018 ). However, in addition to blood pressure control with medications, its management should consider related risk factors and adherence to lifestyle modifications.…”