DETERMINANTS OF MEDICATION ADHERENCE IN HYPERTENSION: EVIDENCE FROM A DIALECTICAL BEHAVIOR THERAPY INTERVENTION
Abstract
Purpose of the Study: The study examined the demographic determinants of medication adherence among patients with hypertension across three time points within a behavioral intervention context.
Statement of the Problem: Despite clear benefits of adherence for blood pressure control and reduced complications, many patients fail to take medications consistently. Sociodemographic and clinical factors may influence adherence, but their role in shaping engagement with treatment remains underexplored.
Methodology: A quasi-experimental design was employed with 80 patients randomly assigned to an experimental group receiving Dialectical Behavior Therapy (DBT) or a control group receiving usual care. Adherence was measured using the Morisky Medication Adherence Scale-8, and demographic data were collected via a researcher-developed questionnaire. Analyses included bivariate comparisons and Generalized Estimating Equations to assess predictors over time.
Results of the Study: At baseline, adherence did not differ across demographic or clinical characteristics. Post-intervention, education emerged as a significant determinant, with its influence increasing over time. Participants were 97% less likely to report moderate-to-high adherence at baseline compared to endline, and odds of adherence nearly doubled between midline and endline, highlighting progressive improvement.
Conclusion and Policy Implications: Higher educational attainment appears to enhance understanding of disease, appreciation of treatment benefits, and capacity to overcome barriers. Integrating health education and behavioral interventions like DBT into chronic disease management can strengthen adherence outcomes. Policymakers and healthcare systems should provide structured support and tailor interventions to demographic contexts, while future research should explore how social, economic, and cultural factors intersect with adherence behavior.
Keywords: Determinants, Medication Adherence, Hypertension, Dialectical Behavior, Therapy Intervention
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