Urban-Rural Difference in Adherence Treatment of Hypertensive Patients In South Sumatra Indonesia

Abstract

Treatment adherence is essential for controlling blood pressure and preventing complications. The availability of information regarding factors related to adherence is needed to design appropriate interventions. However, this information is still limited. This study aims to evaluate medication adherence and identify the main factors associated with hypertension patients living in urban and rural areas. A crosssectional study was conducted in ten primary healthcare facilities in South Sumatra Province, consisting of 5 urban and 5 rural areas, totaling 458 hypertensive patients. Medication adherence was measured using the MGLS questionnaire, social support with the MSPSS, and level of knowledge with HK-LS. Data were analyzed using descriptive statistics, bivariate tests using chi-square, independent T-test, and mann-whitney tests, and then continued multivariate logistic regression analysis. Adherence to hypertension medication in urban (38.2%) and rural (23.6%) areas differed significantly (p=0.000). Medication adherence in urban areas was related to work (OR=4.787, p=0.000), social support (OR=5.054, p=0.000 ), and level of knowledge (OR=6.558, p=0.000). In rural areas, medication adherence is associated with social support (OR=4.696, p=0.000), knowledge level (OR=12.555, p=0.022), high/middle school education (OR =3.290, p=0.000), bachelor or above education (OR=12.871, p=0.000). Most patients are non-adherent to treatment hypertension in urban and rural areas. The factors most related to medication adherence in urban areas were employment status, social support, and knowledge about hypertension, while education, social support, and knowledge were the factors most related to adherence in rural areas. Interventions must be designed based on the information obtained to improve medication adherence.