Factors Associated with Treatment Adherence in People with Both Hypertension and Pre-Diabetes: A Cross-Sectional Study in a Semi-Rural Community in Thailand

Purpose: Hypertension (HTN) combined with prediabetes (pre-DM) has become an important public health concern worldwide. Patients need to adhere to both pharmacological and non-pharmacological treatments in order to regulate both blood pressure and blood glucose levels and reduce the risk of serious complications. This study examined factors associated with treatment adherence in people with both HTN and pre-DM. Methods: A cross-sectional study was conducted between January and March 2025. A sample of 275 people with both HTN and pre-DM was recruited from 11 subdistrict health-promoting hospitals (HPHs) in Sai Noi, a semi-rural district in Nonthaburi Province, Thailand. Data were collected using structured questionnaires. Multiple regression analysis was used to examine factors associated with treatment adherence. Results: It was revealed that female sex, knowledge about HTN and pre-DM/T2DM, social support, patient–provider relationship, convenience of traveling to health services, and convenience in using these services were significantly positively correlated with adherence to treatment. Meanwhile, experience of medication side effects, smoking, and alcohol consumption were negatively correlated with it. The multiple regression model was statistically significant in predicting treatment adherence ( F = 11.36 (5, 269), p < 0.001) and included overall support from family (B = 2.23, p < 0.001), smoking (B = − 132.61, p < 0.001), experience of medication side effects (B = − 89.51, p = 0.004), knowledge of pre-DM/T2DM (B = 14.67, p = 0.013), and patient–provider relationship (B = 2.23, p = 0.033) as significant factors. Conclusion: Disease–related knowledge, support from family, and patient–provider relationship positively influence treatment adherence of people with both HTN and pre-DM, while side effects of medication and smoking negatively influence it. These findings provide valuable insights for health officials that could inform future intervention and management strategies for this dual-risk population. Keywords: treatment adherence, knowledge, social support, patient–provider relationship, side effects, smoking, pre-DM