Abstract
Background: Medication adherence (MA) is the most important controlling factor of high blood pressure (HBP). There are a few MA models, but they have not been successful in predicting MA completely. Thus, this study aimed to expand a conceptual model of MA based on an ecological approach.
Methods: An integrative review of the literature based on theoretical and empirical studies was completed. Data source comprised: Medline (including PubMed and Ovid), ISI, Embase, Google scholar, and internal databases such as Magiran, Google, SID, and internal magazines. Primary English and Persian language studies were collected from 1940 to 2018. The steps of study included: (a) problem identification, (b) literature review and extracting studies, (c) appraising study quality, (d) gathering data, (e) data analysis using the directed content analysis, (f) concluding.
Results: Thirty-six articles were finally included and analyzed. After analysis, predictors of MA in older adults with hypertension were categorized into personal, interpersonal, organizational, and social factors. Although the personal factors have the most predictors in sub-categories of behavioral, biological, psychological, knowledge, disease, and medication agents, social, organizational and interpersonal factors can have indirect and important effects on elderly MA.
Conclusion: There are many factors influencing MA of elderly with HBP. The personal factor has the most predictors. The designed model of MA because of covering all predictor factors, can be considered as a comprehensive MA model. It is suggested that future studies should select factors for study from all levels of the model.
Keywords: Conceptual model, elderly, ecological approach, hypertension, medication adherence, blood pressure.
Graphical Abstract
[1]
Yassine M, Al-Hajje A, Awada S, et al. Evaluation of medication adherence in Lebanese hypertensive patients. J Epidemiol Glob Health 2016; 6(3): 157-67.
[2]
Tocci G, Muiesan ML, Parati G, et al. Trends in prevalence, awareness, treatment, and control of blood pressure recorded from 2004 to 2014 during world hypertension day in Italy. J Clin Hypertens 2016; 18(6): 551-6.
[3]
Cheng HM, Chiang CE, Chen CH. The novelty of the 2015 guidelines of the Taiwan society of cardiology and the Taiwan hypertension society for the management of hypertension. Pulse (Basel) 2015; 3(1): 29-34.
[4]
Conn VS, Ruppar TM, Chase J-AD. Blood pressure outcomes of medication adherence interventions: Systematic review and meta-analysis. J Behav Med 2016; 39(6): 1065-75.
[5]
Bhagavathula A, Abegaz T, Gebreyohannes E, Shehab A. Non-adherence to antihypertensive drugs: A systematic review and meta-analysis. Value Health 2016; 19(7): A657.
[6]
De Geest S, Ruppar T, Berben L, Schönfeld S, Hill MN. Medication non-adherence as a critical factor in the management of presumed resistant hypertension: A narrative review. EuroIntervention 2014; 9(9): 1102-9.
[7]
Dinmohammadi MR, Ramezanibadr F, Peyrovi H, Mehrdad N. Final year experience of BSN students’ in the clinical environment: Professional pride. J Med Educ Devel 2014; 7(15): 39-48.
[8]
Yap AF, Thirumoorthy T, Kwan YH. Medication adherence in the elderly. J Clin Gerontol Geriatr 2016; 7(2): 64-7.
[9]
Toh MR, Teo V, Kwan YH, Raaj S, Tan SYD, Tan JZY. Association between number of doses per day, number of medications and patient’s non-compliance, and frequency of readmissions in a multi-ethnic Asian population. Prev Med Rep 2014; 1: 43-7.
[10]
Robles NR, Macias JF. Hypertension in the elderly. Cardiovasc Hematol Agents Med Chem 2015; 12(3): 136-45.
[11]
Conn VS, Enriquez M, Ruppar TM, Chan KC. Meta-analyses of theory use in medication adherence intervention research. Am J Health Behav 2016; 40(2): 155-71.
[12]
Zhao Y, Chen L, Qi W, Wang B. Application of the health belief model to improve the understanding of antihypertensive medication adherence among Chinese patients. Patient Educ Couns 2015; 98(5): 669-73.
[13]
Jørgensen SE. Overview of the model types available for development of ecological models. Ecol Modell 2008; 215(1-3): 3-9.
[14]
Crosby R, Noar SM. Theory development in health promotion: Are we there yet? J Behav Med 2010; 33(4): 259-63.
[15]
Berben L, Dobbels F, Engberg S, Hill MN, de Geest S. An Ecological perspective on medication adherence. West J Nurs Res 2012; 34(5): 635-53.
[16]
Whittemore R, Knafl K. The integrative review: Updated methodology. J Adv Nurs 2005; 52(5): 546-53.
[17]
Larner AJ. Mini-Mental Parkinson (MMP) as a dementia screening test: Comparison with the Mini-Mental State Examination (MMSE). Curr Aging Sci 2011; 79(2): 219-29.
[18]
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Med 2009; 6(7): W65-94.
[19]
Dixon-Woods M, Cavers D, Agarwal S, et al. Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Med Res Methodol 2006; 6(1): 35.
[20]
Silva AL, Teixeira HJ, Teixeira MJC, Freitas S. The needs of informal caregivers of elderly people living at home: An integrative review. Scand J Caring Sci 2013; 27(4): 792-803.
[22]
Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004; 24(2): 105-12.
[23]
Chapman RH, Petrilla AA, Benner JS, Schwartz JS, Tang SSK. Predictors of adherence to concomitant antihypertensive and lipid-lowering medications in older adults: A retrospective, cohort study. Drugs Aging 2008; 25(10): 885-92.
[24]
Lalić J, Radovanović RV, Mitić B, Nikolić V, Spasić A, Koraćević G. Medication adherence in outpatients with arterial hypertension. Acta Facultatis Medicae Naissensis 2013; 30(4): 209-18.
[25]
Johnson MJ. Adherent and nonadherent medication-taking in elderly hypertensive patients. Clin Nurs Res 1999; 8(4): 318-35.
[26]
de Guzman AB, Guevara KIJ, Guiang FJB, et al. Developing a model of medication adherence among Filipino elderly. Educ Gerontol 2013; 39(5): 298-313.
[27]
Wang W, Lau Y, Loo A, Chow A, Thompson DR. Medication adherence and its associated factors among Chinese community-dwelling older adults with hypertension. Heart Lung 2014; 43(4): 278-83.
[28]
Krousel-Wood MA, Muntner P, Islam T, Morisky DE, Webber LS. Barriers to and determinants of medication adherence in hypertension management: Perspective of the cohort study of medication adherence among older adults. Med Clin North Am 2009; 93(3): 753-69.
[29]
Hekler EB, Lambert J, Leventhal E, Leventhal H, Jahn E, Contrada RJ. Commonsense illness beliefs, adherence behaviors, and hypertension control among African Americans. J Behav Med 2008; 31(5): 391-400.
[30]
Van Wijk BLG, Shrank WH, Klungel OH, Schneeweiss S, Brookhart MA, Avorn J. A cross-national study of the persistence of antihypertensive medication use in the elderly. J Hypertens 2008; 26(1): 145-53.
[31]
Marcum ZA, Zheng Y, Perera S, et al. Prevalence and correlates of self-reported medication non-adherence among older adults with coronary heart disease, diabetes mellitus, and/or hypertension. Res Social Adm Pharm 2013; 9(6): 817-27.
[32]
Kim MM, Howard DL, Kaufman JS, Holmes D. Predicting medication use in an elderly hypertensive sample: Revisiting the established populations for epidemiologic studies of the elderly study. J Natl Med Assoc 2008; 100(12): 1386-93.
[33]
Lee SK, Kang B-Y, Kim H-G, Son Y-J. Predictors of medication adherence in elderly patients with chronic diseases using support vector machine models. Healthc Inform Res 2013; 19(1): 33.
[34]
Gentil L, Vasiliadis HM, Préville M, Bossé C, Berbiche D. Association between depressive and anxiety disorders and adherence to antihypertensive medication in community-living elderly adults. J Am Geriatr Soc 2012; 60(12): 2297-301.
[35]
Turner BJ, Hollenbeak C, Weiner MG, Ten Have T, Roberts C. Barriers to adherence and hypertension control in a racially diverse representative sample of elderly primary care patients. Pharmacoepidemiol Drug Saf 2009; 18(8): 672-81.
[36]
Holt EW, Muntner P, Joyce C, Morisky DE, Webber LS, Krousel-Wood M. Life Events, Coping, and antihypertensive medication adherence among older adults: The cohort study of medication adherence among older adults. Am J Epidemiol 2012; 176(Suppl. 7): S64-71.
[37]
Holt E, Joyce C, Dornelles A, et al. Sex differences in barriers to antihypertensive medication adherence: Findings from the cohort study of medication adherence among older adults. J Am Geriatr Soc 2013; 61(4): 558-64.
[38]
Ruppar TM. Randomized pilot study of a behavioral feedback intervention to improve medication adherence in older adults with hypertension. J Cardiovasc Nurs 2010; 25(6): 470-9.
[39]
Rajpura JR, Nayak R. Role of illness perceptions and medication beliefs on medication compliance of elderly hypertensive cohorts. J Pharm Pract 2014; 27(1): 19-24.
[40]
Wahid H, Ahmad S, Nor MAM, Rashid MA. Prestasi kecekapan pengurusan kewangan dan agihan zakat: Perbandingan antara majlis agama islam negeri di Malaysia. J Ekonomi Malaysia 2017; 51(2): 39-54.
[41]
Rajpura J, Nayak R. Medication adherence in a sample of elderly suffering from hypertension: Evaluating the influence of illness perceptions, treatment beliefs, and illness burden. J Manag Care Pharm 2014; 20(1): 58-65.
[42]
Alcántara C, Edmondson D, Moise N, Oyola D, Hiti D, Kronish IM. Anxiety sensitivity and medication nonadherence in patients with uncontrolled hypertension. J Psychosom Res 2014; 77(4): 283-6.
[43]
McLane CG, Zyzanski SJ, Flocke SA. Factors associated with medication noncompliance in rural elderly hypertensive patients. Am J Hypertens 1995; 8(2): 206-9.
[44]
Hsu Y-H, Mao C-L, Wey M. Antihypertensive medication adherence among elderly Chinese Americans. J Transcult Nurs 2010; 21(4): 297-305.
[45]
Park Y-HH, Kim H, Jang S-NN, Koh CK. Predictors of adherence to medication in older Korean patients with hypertension. Eur J Cardiovasc Nurs 2013; 12(1): 17-24.
[46]
Lee VW, Pang KK, Hui KC, et al. Medication adherence: Is it a hidden drug-related problem in hidden elderly? Geriatr Gerontol Int 2013; 13(4): 978-85.
[47]
Chen C-H, Wu J-R, Yen M, Chen Z-C. A Model of medication-taking behavior in elderly individuals with chronic disease. J Cardiovasc Nurs 2007; 22(5): 359-65.
[48]
Ruppar TM, Dobbels F, De Geest S. Medication Beliefs and antihypertensive adherence among older adults: A pilot study. Geriatr Nurs 2012; 33(2): 89-95.
[49]
Pawar S, Lokhande KD, Padma S, Diwan A. Innovare academic sciences effect of pharmacist mediated patient counseling in hypertensive patients in terms of knowledge, compliance and lifestyle modification Ethical Approval Selection of Patient Consent taken from the Patient Data collected in the P. Int J Pharm Pharm Sci 2014; 6(4): 277-81.
[50]
Obreli-Neto PR, Guidoni CM, De Oliveira Baldoni A, et al. Effect of a 36-month pharmaceutical care program on pharmacotherapy adherence in elderly diabetic and hypertensive patients. Int J Clin Pharm 2011; 33(4): 642-9.
[51]
Murray MD, Morrow DG, Weiner M, et al. A conceptual framework to study medication adherence in older adults. Am J Geriatr Pharmacother 2004; 2(1): 36-43.
[52]
Raymundo ACN, Pierin AMG. Adherence to treatment of hypertensive patients in a chronic disease management program: Longitudinal retrospective study. Revista da Escola de Enfermagem da USP 2014; 48(5): 811-9.
[53]
Schneider PJ, Murphy JE, Pedersen CA. Impact of medication packaging on adherence and treatment outcomes in older ambulatory patients. J Am Pharm Assoc 2008; 48(1): 58-63.
[54]
Chia L, Schlenk EA, Dunbar-Jacob J. Effect of personal and cultural beliefs on medication adherence in the elderly. Drugs Aging 2006; 23(3): 191-202.
[55]
Moultry AM, Pounds K, Poon IO. Managing medication adherence in elderly hypertensive patients through pharmacist home visits. Consult Pharm 2015; 30(12): 710-9.
[56]
Warner LM, Schüz B, Aiken L, et al. Interactive effects of social support and social conflict on medication adherence in multimorbid older adults. Soc Sci Med 2013; 87: 23-30.
[57]
Gerber BS, Cho YI, Arozullah AM, Lee SYD. Racial differences in medication adherence: A cross-sectional study of medicare enrollees. Am J Geriatr Pharmacother 2010; 8(2): 136-45.
[58]
Murray E, Lo B, Pollack L, et al. The impact of health information on the Internet on the physician-patient relationship: Patient perceptions. Arch Intern Med 2003; 163(14): 1727-34.
[59]
Donohue JM, Huskamp HA, Wilson IB, Weissman J. Whom do older adults trust most to provide information about prescription drugs? Am J Geriatr Pharmacother 2009; 7(2): 105-16.
[60]
Ben-Natan M, Noselozich I. Factors affecting older persons’ adherence to prescription drugs in Israel. Nurs Health Sci 2011; 13(2): 164-9.
[61]
Alghurair SA, Hughes CA, Simpson SH, Guirguis LM. A systematic review of patient self-reported barriers of adherence to antihypertensive medications using the world health organization multidimensional adherence model. J Clin Hypertens 2012; 14(12): 877-86.
[62]
Krousel-Wood M, Thomas S, Muntner P, Morisky D. Medication adherence: A key factor in achieving blood pressure control and good clinical outcomes in hypertensive patients. Curr Opin Cardiol 2004; 19(4): 357-62.
[63]
Lewis LM. Factors associated with medication adherence in hypertensive blacks: A review of the literature. J Cardiovasc Nurs 2012; 27(3): 208-19.
[64]
Nielsen J, Shrestha AD, Neupane D, Kallestrup P. Non-adherence to anti-hypertensive medication in low- and middle-income countries: A systematic review and meta-analysis of 92443 subjects. J Hum Hypertens 2017; 31(1): 14-21.
[65]
Brawley LR, Culos-Reed SN. Studying adherence to therapeutic regimens. Control Clin Trials 2000; 21(5): S156-63.
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