Dr. Pharmacology Department, Faculty of Medicine, Universitas Islam Indonesia Sleman, Indonesia
Background: Adherence to medication is important for blood pressure control, which helps lower the risk of morbidity and mortality. The Blood Pressure Action Sheet (BPAS) was developed as written material for supporting patients with hypertension.
Objectives: to evaluate whether the BPAS would help improve patient adherence to antihypertensive medication.
Methods: This was a mixed-method study; a pre–post interventional study was followed by a qualitative study to explore the perspectives of community health workers (CHW) on the implementation of BPAS. The study included members of the Integrated Health Service Post for the Elderly (posyandu lansia) who were 45 years or older and had stage 2 hypertension. The Medication Adherence Rating Scale (MARS) questionnaire was applied. A paired t-test was used to compare the means of the MARS score before and after intervention.
Results: One hundred eight patients met the inclusion criteria. The majority were female (87%) and had a low level of education. The average age was 67.2±9.2 years. After the intervention, the MARS score was significantly higher than before the intervention (20.5±3.4 vs 18.7±4.5; p< 0.05). Before and after the intervention, the percentages of patients who were completely adherent (scoring 24 or 25) were 11.9% and 19.6%, respectively. The percentage of non-adherent patients (MARS score < 20) decreased from 46.2% prior to the intervention to 21.6% three months later. The BPAS was deemed user-friendly, practical, and applicable by CHWs. The challenges in implementation derive from its use with illiterate patients.
Conclusions: The 3-month implementation of the BPAS improved patients’ adherence to antihypertensive medication. However, the patients’ adherence after the intervention remained suboptimal.
