Sociodemographic and Clinical Determinants of Treatment Adherence and Illness Acceptance in Patients With Hypertension

Aims To identify the sociodemographic and clinical factors associated with adherence to blood pressure‐lowering treatment and with illness acceptance in adults with hypertension attending specialist outpatient care. Design Single‐centre cross‐sectional study. Methods We studied 229 adults with physician‐diagnosed hypertension attending routine follow‐up visits at a specialist hypertension clinic. Adherence was measured with the Hill‐Bone Compliance to High Blood Pressure Therapy Scale and illness acceptance with the Acceptance of Illness Scale (AIS). Two multivariable linear regression models with the same 11 sociodemographic and clinical predictors were fitted. Reporting Method STROBE. Results Treatment adherence and illness acceptance were moderately correlated. Medication burden was the only factor independently associated with both poorer treatment adherence and lower illness acceptance. Better adherence was also associated with a higher number of comorbidities, rural residence, and a family history of hypertension, although the latter two associations were less robust after adjustment for multiple testing. Patients with the highest medication burden had the poorest adherence and the lowest illness acceptance. Conclusion Adherence and illness acceptance are related but distinct aspects of living with hypertension. The number of medications was the only factor independently associated with both outcomes, suggesting that medication burden should be considered in individualised care. Implications for the Profession and/or Patient Care Assessing adherence and illness acceptance together may help nurses to separate patients who need education about their treatment from those who need psychological support or a simpler regimen. Impact Adherence and illness acceptance had different determinant profiles in patients with hypertension, with medication burden as the only factor common to both. The findings support individualised nursing assessment and multidisciplinary management of hypertension. Patient or Public Contribution Patients completed validated questionnaires and provided clinical information during routine outpatient visits. They were not involved in the study design, data analysis, interpretation or manuscript preparation.