Factors Influencing Antihypertensive Medication Adherence Among Elderly Patients: A Cross-Sectional Study in Sesayap Hilir, North Kalimantan

Abstract

Hypertension is a chronic condition frequently accompanied by low medication adherence in older adults, contributing to elevated risks of cardiovascular complications. This study aimed to identify the factors influencing medication adherence among elderly patients with hypertension in the working area of the Sesayap Hilir Public Health Center, Tana Tidung Regency. A cross-sectional design was applied involving 258 participants selected through purposive sampling. Data were collected using the 8-item Morisky Medication Adherence Scale (MMAS-8) and a structured questionnaire with researcher developed items to evaluate predisposing, enabling, and reinforcing factors, and were analyzed using chi-square tests and factor analysis. Most participants demonstrated low adherence (81%), had primary level education, reported family income below the regional minimum wage, and had lived with hypertension for at least three years. No significant associations were found between medication adherence and education level (p = 0.388), employment status (p = 0.364), family income (p = 0.082), or hypertension duration (p = 0.657). In contrast, knowledge (p < 0.001), family support (p < 0.001; PR = 24.65), and motivation (p < 0.001; PR = 21.93) were strongly associated with adherence. Factor analysis identified two significant components: psychosocial resources (knowledge, family support, motivation) and demographic–disease factors (education, occupation, illness duration), which together explained 64.45% of the total variance. These findings indicate that psychosocial resources are the predominant determinants of medication adherence among elderly patients with hypertension. Interventions at the primary care level should therefore prioritize strengthening health literacy, enhancing family involvement, and maintaining patient motivation to support long-term treatment adherence.