Application of the Health Belief Model to Antihypertensive Medication Adherence: A Meta-Analysis
Abstract
This study explores several Health Belief Model (HBM) components, such as perceived susceptibility, severity, benefit, barriers, and cues to action. Through the rigorous conduct of a comprehensive systematic review followed by a meticulous meta-analysis, this research intends to determine the impact of HBM constructs on anti-hypertensive medication adherence in hypertensive patients. Nineteen papers in total were chosen for the comprehensive review and analysis in this research, which employed the following PICO elements as Population- those suffering from elevated blood pressure; Intervention - strong Perception of benefits, presence of cues to action, and perceptions of vulnerability; Comparison – week perception of benefits, absence of cues to action, and no perception of vulnerability; Outcome - medication adherence. Data were collected from various databases, including PubMed, Springer Link, Science Direct, and Google Scholar. Meanwhile, data analysis was conducted using RevMan 5.3. 19 articles (2012-2020) Adherence to Hypertensive Medication among Hypertensive Patients with Cross-Sectional Design. The 19 articles included in this study design utilized a cross-sectional study design. The results demonstrated that a strong perception of benefit (aOR= 1.63; 95% CI= 1.05 to 2.52; p= 0.030), cues to action (aOR= 1.63; 95% CI= 1.05 to 2.52; p= 0.030), and perceived vulnerability (aOR= 2.16; CI 95% = 1.59 to 2.93; p< 0.001) were statistically significant factors in increasing medication adherence among hypertensive patients. This study investigates the impact of HBM components, such as perceived benefits and cues of action, on hypertensive medication adherence across various populations, including Vietnam, Taiwan, China, Ethiopia, Egypt, and Ghana.
References
Adinkrah, E., Bazargan, M., Wisseh, C., & Assari, S. (2020). Adherence to Hypertension Medications and Lifestyle Recommendations among Underserved African American Middle-Aged and Older Adults. 1–15.
Almatouq, B. A., Alaryni, A. A., Alghamdi, A., Alhammad, Q. A., & Abdulmalk, A. (2023). Increasing Awareness of Hypertensive Patients About Their Blood Pressure Readings During Clinic Visits in a Tertiary Hospital in Riyadh. 15(1), 1–10. https://doi.org/10.7759/cureus.33257
Alshammari, S. A., Alshathri, A. H., Alshathri, A. H., Aleban, S. A., Alabdullah, D. W., Abukhlaled, J. K., & Aldharman, S. S. (2023). Assessment of Public Knowledge of Hypertension Among the Saudi Population. Cureus, 15(4), 1–9. https://doi.org/10.7759/cureus.37649
Alves, A. M., Rodrigues, A., & Sa-couto, P. (2022). Effect of an Educational Nursing Intervention on the Mental Adjustment of Patients with Chronic Arterial Hypertension : An Interventional Study.
Atibila, F., Hoor, G. Ten, Donkoh, E. T., & Kok, G. (2021). Challenges experienced by patients with hypertension in Ghana: A qualitative inquiry. PLoS ONE, 16(5 May), 1–18. https://doi.org/10.1371/journal.pone.0250355
Basu, S., Garg, S., Sharma, N., & Meghachandra Singh, M. (2019). Improving the assessment of medication adherence: Challenges and considerations with a focus on low-resource settings. Tzu Chi Medical Journal [revista en Internet] 2019 [acceso 25 de julio de 2023]; 31(2): 73-80. 31(2), 73–80. https://doi.org/10.4103/tcmj.tcmj
Campbell, N. R. C., & Niebylski, M. L. (2018). Prevention and control of hypertension. Current Opinion in Cardiology, 29(4), 324–330. https://doi.org/10.1097/hco.0000000000000067
Care, P., Shiraly, R., Jeihooni, A. K., & Shirazi, R. B. (2022). Perception of risk of hypertension related complications and adherence to antihypertensive drugs : a primary healthcare based cross ‑ sectional study. BMC Primary Care, 1–7. https://doi.org/10.1186/s12875-022-01918-1
Cho, Y. G. (2018). Medication Adherence in Korean Hypertensive Patients. Korean Journal of Family Medicine, 39(6), 323–324. https://doi.org/10.4082/kjfm.39.6E
Dai, B., Addai-Dansoh, S., Nutakor, J. A., Osei-Kwakye, J., Larnyo, E., Oppong, S., Boahemaa, P. Y., & Arboh, F. (2022). The prevalence of hypertension and its associated risk factors among older adults in Ghana. Frontiers in Cardiovascular Medicine, 9(December), 1–9. https://doi.org/10.3389/fcvm.2022.990616
Dimmitt, S. B., Stampfer, H. G., Martin, J. H., & Ferner, R. E. (2019). Efficacy and toxicity of antihypertensive pharmacotherapy relative to effective dose 50. British Journal of Clinical Pharmacology, 85(10), 2218–2227. https://doi.org/10.1111/bcp.14033
El-Nahhas, A. F. H. A., Ali, M. M., Husein, A. M. A., & Diab, S. H. A. (2019). Determinant Factors of Noncompliance on Treatment Among Hypertensive Patients Attending Outpatient Clinic in Sohag University Hospital. Sohag Medical Journal, 23(3), 105–110. https://doi.org/10.21608/smj.2019.15183.1037
G/Tsadik, D., Berhane, Y., & Worku, A. (2020). Adherence to antihypertensive treatment and associated factors in central Ethiopia. International Journal of Hypertension, 2020(Cvd), 10–13. https://doi.org/10.1155/2020/9540810
Ghosh, P. K., Harun, M. G. D., Shanta, I. S., Islam, A., Jannat, K. K. E., & Mannan, H. (2023). Prevalence and determinants of hypertension among older adults: A comparative analysis of the 6th and 8th national health surveys of Bangladesh. PLoS ONE, 18(10 October), 1–14. https://doi.org/10.1371/journal.pone.0292989
Girma, F., Emishaw, S., Seged, F. A., & Mekonen, A. (2014). Compliance with Anti-Hypertensive Treatment and Associated Factors among Hypertensive Patients on Follow-Up in Jimma University Specialized Hospital, Jimma, South West Ethiopia: A Quantitative Cross- Sectional Study. Journal of Hypertension- Open Access, 03(05). https://doi.org/10.4172/2167-1095.1000174
Green, A. S., Lynch, H. M., Nanyonga, R. C., Squires, A. P., Gadikota-Klumpers, D. D., Schwartz, J. I., & Heller, D. J. (2020). Assessing providers’ approach to hypertension management at a large, private hospital in Kampala, Uganda. Annals of Global Health, 86(1), 1–8. https://doi.org/10.5334/aogh.2513
Guerrero-García, C., & Rubio-Guerra, A. F. (2018). Combination therapy in the treatment of hypertension. Drugs in Context, 7, 1–9. https://doi.org/10.7573/dic.212531
Hareri, H. A., & Abebe, M. (2012). Assessments of Adherence to Hypertension Medications and Associated Factors among Patients Attending Tikur Anbessa Specialized Hospital Renal Unit, Addis Ababa, Ethiopia 2012. International Journal of Nursing Science, 3(1), 1–6. https://doi.org/10.5923/j.nursing.20130301.01
Hareri, H. A., Abebe, M., & Asefaw, T. (2014). Assessments of Adherence To Hypertension Managements and Its Influencing Factors Among Hypertensive Patients Attending Black. 4(December), 1086–1095.
Helal, R., Abd el-Wahab, F., & Youness, S. (2019). Compliance with Anti–Hypertension Regimen: Prevalence, Predictors and Health Belief Model, Their Effect on Managing Hypertension in Mansoura. A Hospital-Based Study. The Egyptian Journal of Community Medicine, 37(4), 84–94. https://doi.org/10.21608/ejcm.2019.54694
Heydari, H., Kamran, A., Ahari, Ss., Biria, M., & Malepour, A. (2014). Determinants of patient′s adherence to hypertension medications: Application of health belief model among rural patients. Annals of Medical and Health Sciences Research, 4(6), 922. https://doi.org/10.4103/2141-9248.144914
Joho, A. A. (2021). Using the Health Belief Model to Explain the Patient ’ s Compliance to Anti-hypertensive Treatment in Three District Hospitals - Dar. East African Journal of Public Health, 5(1), 50–58.
Jones, C. L. (2015). The Health Belief Model as an Explanatory Framework in Communication Research: Exploring Parallel, Serial, and Moderated Mediation. Health Commun, 30(6), 566–576. https://doi.org/10.7238/a.v0i21.3154
Koya, S. F., Pilakkadavath, Z., Chandran, P., Wilson, T., Kuriakose, S., Akbar, S. K., & Ali, A. (2023). Hypertension control rate in India: systematic review and meta-analysis of population-level non-interventional studies, 2001–2022. The Lancet Regional Health - Southeast Asia, 9, 1–10. https://doi.org/10.1016/j.lansea.2022.100113
Kvarnström, K., Westerholm, A., Airaksinen, M., & Liira, H. (2021). Factors contributing to medication adherence in patients with a chronic condition: A scoping review of qualitative research. Pharmaceutics, 13(7), 1–41. https://doi.org/10.3390/pharmaceutics13071100
Li, W.-W., & Huang, C.-L. (2016). A risk stratification model for antihypertensive medication non-adherence among Chinese immigrants. Asian/Pacific Island Nursing Journal, 1(3), 97–104. https://doi.org/10.9741/23736658.1040
Li, W. W., Kuo, C. T., Hwang, S. L., Hsu, H. T., Li et al, Li, W. W., Kuo, C. T., Hwang, S. L., & Hsu, H. T. (2012). Factors Related to Medication Non-adherence for Patients with Hypertension in Taiwan. J. Clin. Nurs., 21(13–14), 1816–1824. https://doi.org/10.1111/J.1365-2702.2012.04088.X
Li, W. W., Nhung, D. T. K., Lai, W. S., & Hwang, S. L. (2017). Cultural and clinical factors associated with antihypertensive medication adherence in vietnamese policemen. Asian Pacific Island Nursing Journal, 2(1), 11–18. https://doi.org/10.9741/23736658.1039
Long, E., Ponder, M., Bernard, S., & Prevention, S. (2018). Knowledge, attitudes, and beliefs related to hypertension and hyperlipidemia self-management among African-American men living in the Southeastern United States. Patient Educ Couns, 100(5), 1000–1006. https://doi.org/10.1016/j.pec.2016.12.011.Knowledge
Madebo, W. E., Gube, A. A., & Gudisa, G. G. (2018). Compliance to Anti-Hypertensive Treatment and Associated Factors among Hypertensive Patients on Follow Up in Hospitals of Gamo Gofa. 4(1). https://doi.org/10.19080/JOJPH.2018.04.555628
Mao, Y., Ge, S., Qi, S., & Tian, Q. B. (2022). Benefits and risks of antihypertensive medication in adults with different systolic blood pressure: A meta-analysis from the perspective of the number needed to treat. Frontiers in Cardiovascular Medicine, 9(October), 1–12. https://doi.org/10.3389/fcvm.2022.986502
Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223–237. https://doi.org/10.1038/s41581-019-0244-2
Mohammed Nawi, A., Mohammad, Z., Jetly, K., Abd Razak, M. A., Ramli, N. S., Wan Ibadullah, W. A. H., & Ahmad, N. (2021). The Prevalence and Risk Factors of Hypertension among the Urban Population in Southeast Asian Countries: A Systematic Review and Meta-Analysis. International Journal of Hypertension, 2021. https://doi.org/10.1155/2021/6657003
Obirikorang, Y., Obirikorang, C., Acheampong, E., Odame Anto, E., Gyamfi, D., Philip Segbefia, S., Opoku Boateng, M., Pascal Dapilla, D., Brenya, P. K., Amankwaa, B., Adu, E. A., Nsenbah Batu, E., Gyimah Akwasi, A., & Amoah, B. (2018). Predictors of Noncompliance to Antihypertensive Therapy among Hypertensive Patients Ghana: Application of Health Belief Model. International Journal of Hypertension, 2018. https://doi.org/10.1155/2018/4701097
Ojha, U., Ruddaraju, S., Sabapathy, N., Ravindran, V., Worapongsatitaya, P., Haq, J., Mohammed, R., & Patel, V. (2022). Current and Emerging Classes of Pharmacological Agents for the Management of Hypertension. American Journal of Cardiovascular Drugs, 22(3), 271–285. https://doi.org/10.1007/s40256-021-00510-9
Oliveros, E., Patel, H., Kyung, S., Fugar, S., Goldberg, A., Madan, N., & Williams, K. A. (2020). Hypertension in older adults: Assessment, management, and challenges. Clinical Cardiology, 43(2), 99–107. https://doi.org/10.1002/clc.23303
Paczkowska, A., Hoffmann, K., Kus, K., Kopciuch, D., Zaprutko, T., Michalak, M., Nowakowska, E., & Bryl, W. (2021). Impact of patient knowledge on hypertension treatment adherence and efficacy : A single-centre study in Poland. 18. https://doi.org/10.7150/ijms.48139
Pan, Q., Zhang, C., Yao, L., Mai, C., Zhang, J., Zhang, Z., & Hu, J. (2023). Factors influencing medication adherence in elderly patients with hypertension: A single center study in western china. Patient Preference and Adherence, 17(July), 1679–1688. https://doi.org/10.2147/PPA.S418246
Pathak, A., Poulter, N. R., Kavanagh, M., Kreutz, R., & Burnier, M. (2022). Improving the Management of Hypertension by Tackling Awareness, Adherence, and Clinical Inertia: A Symposium Report. American Journal of Cardiovascular Drugs, 22(3), 251–261. https://doi.org/10.1007/s40256-021-00505-6
Pouya Nematzad, P. P., Besharati, F., & Bahare Gholami-Chaboki. (2018). Effects of health belief model in promoting self‑care behaviors among hypertensive older adults. Journal of Education and Health Promotion, January, 1–6. https://doi.org/10.4103/jehp.jehp
Rippe, J. M. (2018). Lifestyle Medicine: The Health Promoting Power of Daily Habits and Practices. American Journal of Lifestyle Medicine, 12(6), 499–512. https://doi.org/10.1177/1559827618785554
Singh, S., Shankar, R., & Singh, G. P. (2017). Prevalence and Associated Risk Factors of Hypertension: A Cross-Sectional Study in Urban Varanasi. International Journal of Hypertension, 2017. https://doi.org/10.1155/2017/5491838
Tsadik, D. G., Berhane, Y., & Worku, A. (2020). Adherence to antihypertensive treatment and associated factors in central Ethiopia. International Journal of Hypertension, 2020(Cvd), 10–13. https://doi.org/10.1155/2020/9540810
Yue, Z., Li, C., Weilin, Q., & Bin, W. (2015). Application of the health belief model to improve the understanding of antihypertensive medication adherence among Chinese patients. Patient Education and Counseling, 98(5), 669–673. https://doi.org/10.1016/j.pec.2015.02.007.
Copyright (c) 2023 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
