Factors influencing medication taking behaviours of a sample of Newfoundland elderly with hypertension

Coady, Regina (1995) Factors influencing medication taking behaviours of a sample of Newfoundland elderly with hypertension. Masters thesis, Memorial University of Newfoundland.

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Abstract

Hypertension has been internationally recognized as a key risk factor for cardiovascular, cerebrovascular and renal disease in adults, particularly in the elderly population. The prevalence of hypertension in the Newfoundland population over 65 year old was 54% for females and 47% for males (Newfoundland Department of Health & Department of National Health & Welfare, 1990); the second highest provincial rate in Canada. Adherence to antihypertensive medication regimens was estimated at approximately 50% in North American adult populations examined. -- The purpose of this study was to determine the factors associated with adherence to antihypertensive medications in a convenience sample of 51 hypertensive patients over 65 years old attending a family practice in St. John's, Newfoundland. The Health Belief Model was used as the conceptual model for the study. Ten selected factors from the Model were examined. Data were collected by structured interviews with participants in their homes using three instruments; (a) modified Weissfeld, Kirscht, and Brock Health Belief Scale, (b) the General Questionnaire, and (c) the Medication Evaluation Record. Adherence was measured using the Medication Evaluation Record which included an examination of medication containers, a medication count, chart review, and questionnaire developed by the interviewer. -- Only 43.1% of the sample were adherent to their antihypertensive medication regimen. General health threats was the only factor from the Health Belief Model which demonstrated a significant association with adherence. Increases in General Health Threats were significantly associated with greater nonadherence using Spearman's rank correlation coefficient (p = .004). Mean diastolic and systolic blood pressures were also significantly associated with adherence (p = .033 and p = .018 respectively). Increased mean blood pressures were associated with greater nonadherence. -- The findings of this study indicated a significant negative relationship between General Health Threats and adherence, suggesting those with greater health threats adhered less to antihypertensive medications. Adherence was also significantly associated with mean diastolic and systolic blood pressure, indicating those who adhered more to antihypertensive medications had better blood pressure control. The implication for nursing and other health care professionals, therefore, includes recognition of the need for continued efforts toward improving adherence. Further research using a larger and more representative elderly population may provide more generalizable findings.

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