Medication non-adherence in hypertension: the role of health literacy, empowerment and medication beliefs

Abstract

Background: The goal of the present study is to investigate the underlying factors of non-adherence in hypertension. Based on the Health Empowerment Model, we examined the role of health literacy and empowerment in patients’ decisions regarding medication adherence. Methods: The cross-sectional survey was administered to a sample of patients (n=101) diagnosed with hypertension (65 male, average age: 64). The patients filled in the following questionnaires: MARS-5 (a medication adherence measure), Newest Vital Sign and Judgment Skills Scale (measuring health literacy), Health Empowerment Questionnaire, Adherence Self-Efficacy Scale and Medication Beliefs Questionnaire. The present preliminary results are based on a correlational analysis. The final sample will consist of 200 participants. Results: There was a significant positive association between participants’ judgment skills regarding medication management and adherence (r=0.267), but not with functional health literacy. There was a significant positive association between adherence and self-efficacy (r=0.541), the meaningfulness sub-dimension of empowerment (r=0.265), and beliefs regarding the necessity of medications (r=.350), while there was a negative link with medication concerns (r=-428). Older age was associated with greater level of adherence (r=0.255). Beliefs in the necessity of medication taking might be a mediator of this relationship as it showed a positive correlation with age (r=0.379). Discussion: Our preliminary results suggest that exploring patients’ health literacy and empowerment alongside their medication beliefs and self-efficacy can provide a deeper understanding of medication non-adherence. The findings can be useful for designing interventions for increasing compliance in hypertension as well as in clinical practice.