Knowledge, Attitudes, and Practices on Antihypertensive Therapy Among Older Patients with Hypertension: Structural Equation Modeling Analysis

Purpose: This study aimed to examine the medication knowledge, attitudes, and practices (KAP) of older hypertensive patients regarding antihypertensive therapy and to confirm the theoretical relationships among these domains. Patients and Methods: A cross-sectional study was conducted from July to October 2023 among older hypertensive patients to assess their KAP regarding antihypertensive therapy. Structural equation modeling (SEM) was employed to assess the relationships among the KAP dimensions. Results: A total of 561 valid responses from older hypertensive patients were included in the final analysis (response rate 74.7%). Older hypertensive patients exhibited a moderate level of knowledge (median 24, IQR 22-26), generally positive attitudes (median 23, IQR 19-24), and practices (median 33, IQR 27-37). SEM analysis revealed that knowledge directly influenced attitude (β=0.497, P<0.001) and practice (β=0.331, P<0.001). Attitude directly influenced practice (β=0.484, P<0.001). Knowledge also indirectly influenced practice through its effect on attitudes (β=0.241, P<0.001). Conclusion: This study largely confirmed the expected KAP pathway in older hypertensive patients receiving antihypertensive therapy, showing that knowledge supports attitudes and, both directly and indirectly, influences practice. Although attitudes and practices were generally favorable, the moderate knowledge level and specific knowledge gaps suggest that targeted educational interventions remain necessary.