Meta-Analysis: Application of Health Belief Model on the Adherence to Antihypertensive Medication
Background: Non-adherence to treatment and lack of understanding of the use of antihypertensive drugs resulted in uncontrolled hypertension. Antihypertensive compliance as a top priority in the treatment of hypertensive patients through the implementation of the Health Belief Model. The purpose of this study was to analyze the effect of perceived benefits and received cues to act on antihypertensive medication adherence.
Subjects and Method: This meta-analysis was conducted using the PRISMA flowchart guideline. The study was conducted using the PICO model, Population: hypertensive patients, Intervention: perceived benefits were strong and received cues to act, Comparison: perceived benefits were weak and did not receive cues to act, Outcome: adherence to antihypertensive medication. The article search process was carried out between 2012 and 2022 using databases from Pub¬Med, Google Scholar, ScienceDirect and ProQuest. Search keywords included “health belief model” OR “perceived benefit” OR “cues to action” AND “adherence antihypertensive” OR “compliance antihypertensive” AND “hypertension” OR “high blood pressure”. Based on the database, there were 13 articles that met the inclusion criteria. Research analysis was carried out using RevMan 5.3 software.
Results: There are 13 articles from the continents of Africa and Asia. There are 9 meta-analysis articles showing that a strong perceived benefit of hypertension treatment is 1.60 times more likely to adhere to antihypertensive treatment than a weak perception of benefit and is statistically significant (aOR = 1.60; 95% CI = 1.06 to 2.41; p = 0.020), and there were 8 articles discussing the effect of getting cues to act on hypertension treatment on 1.52 times more likely to adhere to antihypertensive medication than not getting cues to act and statistically significant (aOR = 1.52; 95% CI = 1.02 to 2.27; p = 0.040).
Conclusion: Strong and signaled benefit perception for hypertensive patients improves adherence to antihypertensive medication.
Keywords: hypertension, health belief model, perceived benefits, cues to action.
Eltigeka Devi Apriliani, Masters Program in Public Health, universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: firstname.lastname@example.org. Mobile: +62 85735387363.
Journal of Health Promotion and Behavior (2022), 07(03): 238-249
Alam RI, Jama F (2020). Analisis faktor yang mempengaruhi ketidakpatuhan berobat lansia penderita hipertensi di wilayah kerja puskesmas pampang (Analysis of factors that influence non-adherence to treatment for elderly patients with hypertension in the work area of Pampang Public Health Center). Jurnal Ilmiah Kesehatan. 9(2): 115–125. DOI: 10.123¬45/jikp. v9i02.173.
Arindari DR, Suswitha D (2020). Faktor health belief model terhadap kepatuhan minum obat pada penderita hipertensi di puskesmas punti kayu palembang, indonesia (Health belief model factors on medication adherence in patients with hypertension at the Punti Kayu Palembang Public Health Center, Indonesia). Jurnal Kepe¬rawatan. 11(1): 22–27. DOI: 10.22219/jk. v11i1.10483.
El-Nahhas AFHA, Ali MM, Hussein AMA, Diab SHA (2019). Determinant factors of noncompliance on treatment among hypertensive patients attending outpatient clinic in sohag university hospital. Sohag Journal of Sci¬ences. 23(3): 105–110. DOI: 10.21608/smj.2019.15183.1037.
G/Tsadik D, Berhane Y, Worku A (2020). Adherence to antihypertensive treatment and associated factors in central ethiopia. Int. J. Hypertens. 2020: 10–13. DOI: 10.1155/2020/9540810.
Girma F, Emishaw S, Alemseged F, Mekonnen A (2014). Compliance with antihypertensive treatment and associated factors among hypertensive patients on follow-up in jimma university specialized hospital, jimma, south west ethiopia: a quantitative cross-sectional study. Int J Hypertens. 3(5): 1-6. DOI: 10.4172/2167-1095.1000174.
Hareri HA, Abebe M (2012). Assessments of adherence to hypertension medications and associated factors among patients attending tikur anbessa specialized hospital renal unit, addis ababa, ethiopia 2012. J. Clin. Nurs. 3(1): 1–6. DOI: 10.5923 /j.nursing.20130301.01.
Hareri HA, Abebe M, Asefaw T (2014). Assessments of adherence to hypertension managements and its influencing factors among hypertensive patients attending black. Int. J. Pharm. Sci. Res. 4(12): 1086–1095. DOI: 10.13040/ IJPSR.0975¬8232.4-(3).1086-95.
Helal R, El-Wahab AF, Youness S (2019). Compliance with antihypertension regimen: prevalence, predictors and health belief model, their effect on managing hypertension in mansoura. A Hospital-Based Study. The Egypt. J. Community Med. 37(4): 84–94. DOI: 10.21608 /ejcm.2019.54694.
Kamran A, Ahari SS, Biria M, Malepourr A, Heydari H (2014). Determinants of patient′s adherence to hypertension medications: application of health belief model among rural patients. Ann Med Health Sci Res. 4(6): 922927. DOI: 10.4103/2141-9248.14-4¬914.
Li WW, Kuo C-T, Hwang S-L, Hsu H-T (2012). Factors related to medication non-adherence for patients with hypertension in taiwan. J. Clin. Nurs. 21(2018): 1816–1824. DOI: 10.1111/j.1365-2702.2012.04088.x.
Li WW, Huang CL (2016). A risk stratification model for anti hypertensive medication non-adherence among chinese immigrants. Asian Pac Isl Nurs J. 1(3): 97–104. DOI: 10.9741/-23736658.1040.
Li WW, Nhung DTK, Lai W-S, Hwang S-L (2017). Cultural and clinical factors associated with antihypertensive medication adherence in vietnamese policemen. Asian Pac Isl Nurs J. 2(1): pp. 11–18. DOI: 10.9741/23736658. 1039
Madebo WE, Gube AA, Gudisa GG (2018). Compliance to antihypertensive treatment and associated factors among hypertensive patients on follow up in hospitals of gamo gofa. JOJ Pub Health. 4(1): 1-8 DOI: 10.19080/JOJPH.2018.04.555628.
Obirikorang Y, Obirikorang C, Acheampong E, Anto EO, Gyamfi D, Sagbefia SP, Boateng MO, et al. (2018). Predictors of noncompliance to antihypertensive therapy among hypertensive patients ghana: application of health belief model. Int. J. Hypertens. 2018: 1-9. DOI: 10.1155/2018/4701097.
Oparil S, Acelajado MC, Bakris GL, Berlowitz DR, Cifkova R., Dominiczak AF, Grassi G, et al. (2019). Hypertension. Nat Rev DisPrimers. 22(4): 1–48. DOI: 10.1038/nrdp.2018.14.
Rachman RA, Noviati E, Kurniawan R (2021). Efektifitas edukasi health belief models dalam perubahan perilaku pasien hipertensi: literatur review. J. Nurs. Healthc. Res. 3(1): 71–80. DOI:10.35568/healthcare.v3i1.1091.
Tay LK (2019). Factors affecting adherence with medication among hypertension patients attending khawu government hospital. Thesis. Master of Public Health Degree, University of Ghana
Ulfah N (2018). Motivasi pasien penderita hipertensi yang berobat di puskesmas pisangan dalam pengendalian hipertensi (Motivation of patients with hypertension who seek treatment at the Banana Health Center in controlling hypertension). Laporan Penelitian.Program Studi Kedokteran, Fakultas Kedokteran, Universitas Islam Negeri Syarif Hidayatullah.
WHO (2021). Hypertension. Retrieved from: https://www.who.int/news-room/factsheets/detail/hyperten¬sion. Accessed in March 22, 2022.
Widiyanto A, Murti B, Soemanto RB (2018). Multilevel Analysis on The Effect of Socio-Cultural, Lifestyle factors, and School Environment, on the Risk of Overweight in Adolescents, Karanganyar District, Central Java. J. Epidemiol. Public Health. 3(1):94-104. DOI: 10.26911/jepublic-health.2018.03.01.08
Yue Z, Li C, Bin W (2015). Application of the health belief model to improve the understanding of antihypertensive medication adherence among chinese patients. Patient Educ Couns. 98(5): 669–673. DOI: 10.1016/j.pec.2015.02.00