Adherence Behaviors and Related Factors Among Elderly Hypertensive Patients in China: Evidence from the China Health and Retirement Longitudinal Study

Fengyu Liu; Huajing Chang; Xiaojun Liu

doi:10.2147/PPA.S445789

Adherence Behaviors and Related Factors Among Elderly Hypertensive Patients in China: Evidence from the China Health and Retirement Longitudinal Study

Patient Prefer Adherence. 2023 Dec 23:17:3539-3553. doi: 10.2147/PPA.S445789. eCollection 2023.

Authors

Fengyu Liu^#^{1

2}, Huajing Chang^#¹, Xiaojun Liu^{1

3}

Affiliations

¹ School of Public Health, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
² School of Public Health, National Key Laboratory of Health Technology Assessment (National Health Commission of the People's Republic of China), Global Health Institute, Fudan University, Shanghai, People's Republic of China.
³ School of Health Management, Provincial Research Center for Healthcare Reform and Development of Fujian, Health Research Institute, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.

^# Contributed equally.

Abstract

Background: Non-adherence or partial adherence is the main reason for poor therapeutic effect of hypertension. This paper aims to assess adherence behaviors and related factors among elderly hypertensive patients in China.

Methods: Participants aged ≥60 years, with hypertension, and with complete data in 2018 interviews of the China Health and Retirement Longitudinal Study (CHARLS) were included. The adherence behaviors included medication, blood pressure monitoring and the combined adherence behaviors. Referring to the social-ecological theory, correlates of adherence behaviors were divided into three layers, namely demographic characteristics, health behaviors, living environment and retirement. Univariate and multivariable logistic regression models were performed to identify factors of adherence behaviors.

Results: The prevalence of medication adherence (76.58%) was higher than that of blood pressure monitoring adherence (20.08%), and the full adherence rate was 18.53%. Self-rated health status, smoking status, living area, and health education status were detected to be associated with medication adherence and blood pressure monitoring adherence (all p < 0.05). Gender, sleep duration, health examination, and physical exercise were also detected to be associated with blood pressure monitoring adherence (all p < 0.05). Self-rated health status and health education status were detected to be associated with partially and fully adherence, while age, living area, and life satisfaction were detected to be associated with partially adherence, smoking status, sleep duration, health examination, and pension reliance were detected to be associated with fully adherence (all p < 0.05).

Conclusion: Our study reveals the poor adherence behaviors of elderly hypertensive patients in China. This is most evident among those who were male, 60-69 years old, living in rural areas, self-reported being healthier, those without health examination and health education. Targeting these vulnerable populations, we suggest to strengthen health education, increase the publicity of basic public health services and enhance the self-management ability of hypertensive patients.

Keywords: behavior; blood pressure monitoring; elderly; hypertension; medication adherence.

Grants and funding

The present study was mainly supported by the National Natural Science Foundation of China (Grant No. 72204047). Meanwhile, this work was also partially supported by the Natural Science Foundation of Fujian Province, China (Grant No. 2022J01234).