Factors Influencing Medication Adherence and Health Literacy Among Elderly Women in Suburban Iran: A Bayesian Logistic Regression Study

Introduction: Aging populations, particularly women who live 6–8 years longer than men, face health challenges like hypertension. Menopause increases risks for elderly women, making hypertension a significant global public health issue. This study explored the factors influencing medication adherence among elderly women with hypertension residing in suburban areas. Methods: This cross-sectional study involved 267 elderly women with a history of hypertension who were referred to comprehensive health service centers and health bases in the suburban areas of Hamadan city. The study employed three main tools: the WHO’s 5-dimensional model, the health literacy questionnaire for Iranian adults, and the Morisky Medication Adherence questionnaire, using a two-stage sampling method. Data analysis was performed using Bayesian Logistic Regression and Bayesian Linear Regression. Results: 23.2% exhibited good medication adherence, 50.9% exhibited suboptimal adherence, and 25.9% showed good adherence but lacked health literacy. Factors associated with medication adherence included marital status (OR: 3.816; 95% CI: 1.308-9.234), having literacy (OR: 0.477; 95% CI: 0.197-0.951), having good income status (OR: 0.109; 95% CI: 0.002-0.522), number of diseases (OR: 1.173; 95% CI: 1.055-1.307), health literacy (OR: 1.057; 95% CI: 1.021-1.095), care team/ health system (OR: 0.951; 95% CI: 0.909-0.994), and barriers (OR: 1.155; 95% CI: 1.007-1.321). Factors associated with health literacy were literacy (B: 9.469; 95% CI: 6.87-12.06) and selfefficacy (B: 1.263; 95% CI: 0.75-1.78). Discussion: This study identifies four essential strategies to improve medication adherence among elderly hypertensive women in suburban Iran: enhancing practical health literacy, strengthening self-efficacy, leveraging family support (especially from spouses), and reforming the healthcare system to promote patient-centered education. Conclusion: The study emphasizes the importance of improving health literacy and addressing factors impacting medication adherence among elderly women with hypertension in Iran. Enhancing adherence through clear, tailored information can lead to better health outcomes in this group.