Latent Class Analysis of Medication Adherence and Its Influencing Factors Among Rural Hypertensive Patients in Shanxi Province, China.

PURPOSE: To establish latent classes of medication adherence and related influencing factors of hypertensive patients residing in rural areas of Shanxi Province as references to improve medication adherence.

PATIENTS AND

METHODS

Patients diagnosed with primary hypertension were randomly selected from three counties in Shanxi Province from May to July 2024 using a multistage cluster random sampling method. Patient data were collected using a questionnaire that captured basic demographic information, medication knowledge, medication beliefs, and medication adherence. Latent class analysis (LCA) was employed to differentiate medication adherence patterns among the participants. Univariate and multinomial logistic regression analyses were conducted to compare socio-demographic characteristics, medication usage, medication-related knowledge, and medication beliefs in order to identify significant predictors across medication adherence classes.

RESULTS

LCA identified three distinct subtypes of medication adherence among hypertensive patients (n = 739) in rural Shanxi Province: high (58.3%), low (19.8%), and forgetful (21.9%). The entropy value of 0.910 indicated excellent classification quality. Multinomial logistic regression analysis indicated that patients with no/mild/moderate burden of hypertension treatment and mild depression were more likely to be assigned to the low medication adherence group. Conversely, higher self-efficacy scores were positively associated with categorization into the high medication adherence group (p < 0.05). As compared to the forgetful non-adherent group, male participants and higher medication knowledge scores were more likely to be classified into the high medication adherence group (p < 0.05).

CONCLUSION

Medication adherence among hypertensive patients residing in rural areas can be categorized into three main types (high, low, and forgetful) and five primary influencing factors were identified (sex, treatment burden, depressive mood, medication knowledge, and self-efficacy). Enhancing family support, improving medication-related knowledge, and strengthening self-efficacy can effectively improve medication adherence of hypertensive patients.