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Relationship between patients’ knowledge and medication adherence among patients with hypertension

Authors Jankowska-Polańska B, Uchmanowicz I, Dudek K, Mazur G

Received 14 July 2016

Accepted for publication 14 September 2016

Published 7 December 2016 Volume 2016:10 Pages 2437—2447

DOI https://doi.org/10.2147/PPA.S117269

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen

Beata Jankowska-Polańska,1 Izabella Uchmanowicz,1 Krzysztof Dudek,2 Grzegorz Mazur3

1Department of Clinical Nursing, Wroclaw Medical University, 2Department of Transport Systems, Faculty of Mechanical Engineering, Wroclaw University of Technology, 3Department and Clinic of Internal and Occupational Diseases and Hypertension, Wroclaw Medical University, Wroclaw, Poland


Objective: The purpose of this study was to investigate the relationship between knowledge on arterial hypertension (AH) and its management, and adherence to pharmaceutical treatment.
Methods: The study included 233 patients diagnosed with AH and treated with hypotensive drugs for at least 1 year. The 8-item © Morisky Medication Adherence Scale (MMAS-8) and the Hypertension Knowledge-Level Scale (HK-LS) were used.
Results: Sixty-three percent of the patients had a low level of knowledge on AH, with the smallest proportion of correct answers provided for items related to non-pharmaceutical treatment, diet, hypertension definition, and drug adherence. When compared to patients with a high level of knowledge, those with a low knowledge had lower scores in the MMAS (6.45±1.45 vs 7.08±1.04; P=0.038). Multiple-factor analysis showed that statistically significant independent determinants of good adherence included a high level of knowledge (β=0.208; P=0.001), non-pharmaceutical treatment (β=0.182; P=0.006), and frequent blood pressure measurements (β=0.183; P=0.004). The most significant factor in MMAS was knowledge in the “drug adherence” domain (ρ=0.303; P<0.001).
Conclusion: Patients’ knowledge on hypertension is a significant independent determinant of good adherence. Other independent determinants include non-pharmaceutical treatment and regular blood pressure measurements.
Implication for practice: The identification of knowledge deficits as a factor contributing to lack of adherence and poor hypertension control remains a key challenge for multidisciplinary team caring for patients with hypertension.

Keywords: medication adherence, arterial hypertension, medical knowledge

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