Analysis of the Current Status and Moderated Mediating Effect of Medication Beliefs, Medication Adherence, and Social Support Among Elderly Individuals with Polypharmacy in Rural Hangzhou, China

Abstract

Abstract Objective This study aims to examine the prevailing level of medication adherence among elderly individuals residing in rural areas of Hangzhou, China, who experience polypharmacy. The objective is to analyze the factors influencing medication compliance and validate the moderated mediation model. Ultimately, the findings will serve as a valuable reference and foundation for enhancing medication adherence among the rural elderly population with polypharmacy. Methods A convenience sampling method was employed to survey 220 rural elderly patients with chronic diseases requiring multiple drug use across five administrative districts (counties) of Hangzhou. Data were collected through a general information questionnaire, a medication knowledge and attitude questionnaire, and the Chinese version of the MORISKY Medication Adherence Questionnaire (MMAS-8). A total of 240 questionnaires were distributed, and 220 valid responses were obtained. Results Among 220 community elderly patients with polypharmacy, 36 cases (16.4%) had good compliance, 50 cases (22.7%) had strong belief in taking medicine, 2 cases (0.9%) had high knowledge ability of taking medicine, and 91 cases (41.4%) had high social support ability. Results from the univariate analysis revealed statistically significant associations (P < 0.05) with age, education level, medication knowledge, medication belief, and social support. Social support capacity partially mediated the relationship between medication belief and medication adherence, accounting for 14.8% of the total effect (P < 0.001). Furthermore, education level moderated the effects of medication belief and social support capacity (P < 0.05), culminating in a moderated mediation model. Conclusion Greater attention should be devoted to polypharmacy among the elderly, particularly in rural areas. By implementing targeted interventions and comprehensive measures, personalized intervention programs should be refined, and policy guidance and implementation should be reinforced. Moreover, efforts to enhance the capabilities of family doctors and community nursing in rural areas are crucial to ensuring the long-term efficacy of health education, promoting optimal utilization of support, and improving medication utilization among the rural elderly population.