Medication Adherence and Perceived Social Support of Hypertensive Patients in China: A Community-Based Survey Study

Bingjie Shen, Tianjia Guan, Xinyu Du, Chenyang Pei, Jinhong Zhao, Yuanli Liu School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of ChinaCorrespondence: Yuanli Liu, School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, 46 Xizongbu Hutong, Dongcheng District, Beijing, 100005, People’s Republic of China, Tel +86 13522592907, Fax +86 10 65105830, Email yliu@pumc.edu.cnPurpose: Previous studies suggested perceived social support has impact on medication adherence among hypertensive patients, but did not simultaneously elucidate the different contents or key providers of social support that patients perceived. This study was to identify the contents and providers of perceived social support beneficial for improving medication adherence among hypertensive patients in China, which could prove important for targeted interventions.Patients and Methods: Following a multi-stage stratified sampling framework, a total of 903 hypertensive patients from 12 primary health institutions across a middle-income city were recruited from April to June 2021. Medication adherence was measured using the Chinese version of the Morisky, Green and Levine scale; perceived social support was determined using the name generator method. A binary logistic regression model was performed to identify the association between medication adherence and perceived social support. The contents of support included informational, emotional, and instrumental support (finances and caregiving). The support providers included spouse/partner, children, parents, siblings, other relatives, and friends.Results: A total of 506 (56.04%) patients optimally adhered to their antihypertensive medication. Female, older, urban patients, patients with shorter duration of hypertension and antihypertensive medications used showed better adherence (P< 0.05). Optimal medication adherence was positively associated with the overall score of caregiving support (adjusted odds ratio [AOR] = 1.128; 95% confidence interval [CI] = [1.013– 1.257]), informational support from the spouse/partner (AOR = 1.574; 95% CI = [1.112– 2.227]), emotional support from the spouse/partner (AOR = 1.430; 95% CI = [1.032– 1.981]), financial support from the spouse/partner (AOR = 1.439; 95% CI = [1.069– 1.937]) and caregiving support from the spouse/partner (AOR = 1.652; 95% CI = [1.130– 2.414]), whereas optimal medication adherence was negatively associated with caregiving support from friends (AOR = 0.499; 95% CI = [0.286– 0.872]).Conclusion: Informational, emotional, financial and caregiving support from spouses/partners have positive impacts on optimal medication adherence of hypertensive patients of community-level. Community-based interventions designed to improve medication adherence of hypertensive patients should target both patients and their spouses/partners; spouses/partners could be encouraged to provide various support to improve the medication adherence of hypertensive patients.Keywords: medication adherence, perceived social support, spouse, hypertension, China