Cultural Factors Associated with Antihypertensive Medication Adherence

Wednesday, 9 July 2008
Hsin-Tien Hsu, RN, PhD , College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
Shiow-Li Hwang, RN, DNSc , Nursing, Chang Gung Institute of Technology, Tao-Yuan, Taiwan
Chi-Tai Kuo, MD, PhD , The First Cardiovascular Division, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
Ya-Chuan Tseng, RN, MSN , Department of Nursing, National Taiwan University, Sanchung City, Taiwan
Ming-I Fan, MAP, MHSM, RN , Nursing Department, Chang Gung Institute of Technology, Tao-Yuan, Taiwan
Mei-Yu Chiu, RN, BS , General affairs office, Chang Gung Institute of Technology, Taoyuan, Taiwan

Learning Objective 1: explore cultural factors on medication adherence in hypertensive patients in Taiwan.

Learning Objective 2: understand how to help health professionals develop culturally appropriate antihypertensive regimens to control blood pressure of patients

Significance & Problem: Hypertension is a global health problem, including in Taiwan.

Purpose: To explore cultural factors on medication adherence in hypertensive patients in Taiwan.

Data Analysis: Descriptive analyses.

Methods: A prospective, longitudinal, and follow-up design was used. The 200 subjects were recruited from the teaching hospital. The participants were asked to complete questionnaires including demographic data, hypertension knowledge, perceived susceptibility and severity for hypertension, health perceptions (hypertension, Western medications and Chinese herb), social support (family & friend social support, general social support, and relationship with health professionals), medication adherence self-efficacy. Baseline data were analyzed in this report.

Findings: (1) The mean score of knowledge was high (20.322.56)(score range :0-24)and the average of the correct rate was 84.6%;(2) Over half of the participants (52-75%) agreed that they had hypertension because of stress, anxiety, hurry, unhealthy eating style, too much hot-nature food, and blocked blood vessels; (3) They perceived they had low risk (9.353.83)(score range :5-25)for specific disease (ex heart attack, stroke) due to hypertension but had high risk (8.360.98)(score range :2-10)for suffering ill effects of general disease; (4) of subjects, 57% did not agree Chinese Herbs is no side effects due to natural property of Chinese herbs; 50% agree that Chinese Herbs can maintain and balance health. 49% disagree with Chinese medicine treat basic health problems, not just symptoms; (5) of subjects,61% thought it is time-consuming to prepare herbs; 79% agree the lower effectiveness on herbs than Western medications; (6) subjects agreed (7.933.83)(score range :2-10) the quick action and effectiveness of Western medication in decreasing blood pressure (7) 34% experienced side effects from Western medication and 27% agreed Western medication does not treat radical health problems; (8) The 43.0 to 76.0%respondents did beneficial self-care behaviors every day; (9) The participants had good health-related support from family or friends (26.363.79)(score range :7-35) and good social support in general (21.504.85)(score range :6-30). (10) Self-Efficacy score was high (8.721.39)(score range :0-10)(11) Data from three Medication Compliance Scales showed the subjects exhibited high medication compliance.

Implication for Nursing Practice: The findings provided health care providers update information and help develop culturally appropriate antihypertensive regimens to enhance control of blood pressure.