Evaluation of medication adherence according to self-efficacy level of hypertension patients

Objective: The study included people with hypertension over the age of 18 years who applied to the outpatient clinics of Akdeniz University Hospital, agreed to participate in the study and gave consent. It was aimed to determine the relationship between self-efficacy levels and medication adherence of people with hypertension and the factors affecting them. Method: Our study, which is a descriptive and cross-sectional study, was conducted face-to-face via a questionnaire. The participants who agreed to participate in the study were administered the Hypertension Self-Efficacy Scale to assess sociodemographic characteristics, self-efficacy level and the Modified Morisky Scale to determine medication compliance by face-to-face interview technique. Data were analysed using IBM SPSS Statistics 25 © Copyright SPSS Inc. 1989, 2017 software. Statistical significance level was accepted as p<0.05. Results: The mean age of 307 participants was 56.67±11.21 years. 61.9% of the participants were female, 74.9% were married, 34.9% were primary school and university graduates. It was found that 56.4% of the participants had an income level equivalent to their expenses, 43.6% lived with their spouses and children, 35.2% had a diagnosis of hypertension disease for at least 5 and at most 14 years, and 81.8% had a blood pressure monitor at home. Among the participants, 45.3% never exercised, 47.2% never smoked, and 89.3% did not drink alcohol. The mean Hypertension Self-Efficacy Scale score of the patients was calculated as 56.4±8.65, and 76.9% of the patients were grouped as highly motivated and 84% as highly informed according to the Modified Morisky Scale. The Hypertension Self-Efficacy Scale Score of the patients in the high motivation and high knowledge categories was found to be statistically significantly higher than the patients in the low motivation and low knowledge categories (p<0.001). A significant relationship was found between the education level of the participants and the medication adherence knowledge level score (p=0.019). Primary school graduates, high school graduates and university graduates were significantly more likely to be in the high knowledge category than illiterate patients. A significant relationship was found between having a blood pressure monitor, exercising and smoking and hypertension self-efficacy score (p=0.004, p<0.001 and p=0.004, respectively). Conclusion and Recommendations: Hypertension is a chronic disease with high prevalence and serious complications. In order to ensure blood pressure regulation and prevent complications, it is important to support patients after diagnosis, to improve their self-efficacy and thus their capacity to cope with the disease, and to increase their medication compliance. In our study, it was found that the level of knowledge and motivation about medication adherence and self- efficacy scores of the patients were high. For the success of hypertension management, it may be recommended to provide counselling on empowerment of hypertensive patients and their families, and to plan interventions to increase patients' medication compliance and self-efficacy. Keywords: Hypertension, knowledge, motivation, self-efficacy, medication adherence.