Key result
Health education is linked to ~3.6-fold higher odds of full hypertension adherence in elderly patients.
Why the study?
Non-adherence or partial adherence is the main reason for poor therapeutic effect in hypertension, prompting an assessment of adherence behaviors and related factors among elderly hypertensive patients in China.
Cross-Sectional (n=5,175)
Yes
Odds Ratio: 3.56 (95% CI 2.8–4.53)
p-value: p=<0.05
Elderly hypertensive patients in China show very low rates of combined adherence (18.53%), particularly driven by poor blood pressure monitoring adherence, emphasizing a need for enhanced health education.
Low full adherence in elderly Chinese hypertensives signals monitoring gaps; health education association is hypothesis-generating pending prospective trials.
Background: Non-adherence or partial adherence is the main reason for poor therapeutic effect of hypertension. This paper aims to assess adherence behaviors and related factors among elderly hypertensive patients in China. Methods: Participants aged ≥ 60 years, with hypertension, and with complete data in 2018 interviews of the China Health and Retirement Longitudinal Study (CHARLS) were included. The adherence behaviors included medication, blood pressure monitoring and the combined adherence behaviors. Referring to the social-ecological theory, correlates of adherence behaviors were divided into three layers, namely demographic characteristics, health behaviors, living environment and retirement. Univariate and multivariable logistic regression models were performed to identify factors of adherence behaviors. Results: The prevalence of medication adherence (76.58%) was higher than that of blood pressure monitoring adherence (20.08%), and the full adherence rate was 18.53%. Self-rated health status, smoking status, living area, and health education status were detected to be associated with medication adherence and blood pressure monitoring adherence (all p < 0.05). Gender, sleep duration, health examination, and physical exercise were also detected to be associated with blood pressure monitoring adherence (all p < 0.05). Self-rated health status and health education status were detected to be associated with partially and fully adherence, while age, living area, and life satisfaction were detected to be associated with partially adherence, smoking status, sleep duration, health examination, and pension reliance were detected to be associated with fully adherence (all p < 0.05). Conclusion: Our study reveals the poor adherence behaviors of elderly hypertensive patients in China. This is most evident among those who were male, 60– 69 years old, living in rural areas, self-reported being healthier, those without health examination and health education. Targeting these vulnerable populations, we suggest to strengthen health education, increase the publicity of basic public health services and enhance the self-management ability of hypertensive patients.
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Liu et al. (2023) conducted a cross-sectional in Hypertension (n=5,175). Health education vs. No health education was evaluated on Full adherence (both medication adherence and blood pressure monitoring ≥12 times/year) (AOR 3.56, 95% CI 2.80-4.53, p=<0.05). Among elderly Chinese patients with hypertension, the full adherence rate was 18.53%, and receiving health education was significantly associated with higher odds of full adherence (AOR 3.56).
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