Clinical Interventions in Aging (Nov 2018)
Factors influencing adherence to treatment in older adults with hypertension
Abstract
Bartosz Uchmanowicz,1 Anna Chudiak,1 Izabella Uchmanowicz,1 Joanna Rosińczuk,2 Erika Sivarajan Froelicher3,4 1Division of Nursing in Internal Medicine Procedures, Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland; 2Department of Nervous System Diseases, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland; 3Department of Physiological Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, USA; 4Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, USA Purpose: Hypertension (HT) is considered to be the most common disorder in the general population. Demographic data indicate that older adults commonly suffer from HT. Older age is one of the key factors affecting the adherence of patients with HT. The main purpose was to identify demographic, socioeconomic, and clinical factors that affect adherence in older adults with HT. Materials and methods: This cross-sectional study included 150 patients (84 women and 66 men) with mean age of 72.1 years. The Hill-Bone Compliance to High Blood Pressure Therapy Scale (Hill-Bone CHBPTS) was used to evaluate the adherence to therapeutic recommendations for HT. Results: The mean score obtained by the patients in the Hill-Bone CHBPTS was 20.19 (SD±4.05). The linear regression model showed the independent predictors of the total score (P<0.05): 1) age, each subsequent year of life raises the total score by an average of 0.2 points; 2) gender, males raise it by an average of 1.34 points compared to females; 3) education, a secondary, higher, or higher professional education lowers it by an average of 1.75 points compared to a primary education or no education; and 4) living with the family, having familial support lowers it by an average of 1.91 points compared to living alone or in an organized institution. Conclusion: Our study has shown that the variables of age, education level, and living with the family were statistically significant in explaining the adherence rates. Health care professionals should pay more attention to older HT patients who have a low level of education and who experience the lack of social support. There is a need for a tailored education among this group of patients to better understand and adhere to medication treatment. Keywords: elderly patients, hypertension, Hill-Bone scale, socioeconomic factors, clinical factors, cardiac nursing, health care providers
