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Cited by 19Medication Adherence and CompliancePharmacy and Medical PracticesBlood Pressure and Hypertension Studies

Conceptual Model of Medication Adherence in Older Adults with High Blood Pressure-An Integrative Review of the Literature

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Oori, Mehdi Jafari, Mohammadi, Farahnaz, Norouzi, Kian, Fallahi-Khoshknab, Masoud, Ebadi, Abbas·2019·Current Hypertension Reviews
DOI 10.2174/1573402114666181022152313PMC PMC6635648
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Abstract

Background: Medication adherence (MA) is the most important controlling factor of high blood pressure (HBP). There are a few MA models, but they have not been successful in predicting MA completely. Thus, this study aimed to expand a conceptual model of MA based on an ecological approach. Methods: An integrative review of the literature based on theoretical and empirical studies was completed. Data source comprised: Medline (including PubMed and Ovid), ISI, Embase, Google scholar, and internal databases such as Magiran, Google, SID, and internal magazines. Primary English and Persian language studies were collected from 1940 to 2018. The steps of study included: (a) problem identification, (b) literature review and extracting studies, (c) appraising study quality, (d) gathering data, (e) data analysis using the directed content analysis, (f) concluding. Results: Thirty-six articles were finally included and analyzed. After analysis, predictors of MA in older adults with hypertension were categorized into personal, interpersonal, organizational, and social factors. Although the personal factors have the most predictors in sub-categories of behavioral, biological, psychological, knowledge, disease, and medication agents, social, organizational and interpersonal factors can have indirect and important effects on elderly MA. Conclusion: There are many factors influencing MA of elderly with HBP. The personal factor has the most predictors. The designed model of MA because of covering all predictor factors, can be considered as a comprehensive MA model. It is suggested that future studies should select factors for study from all levels of the model.

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  • Interconnectivity between the WHO dimensions is an important aspect of medication adherence, supported by a number of conceptual frameworks but missing or not fully considered in others.

    “A white rim surrounding the five dimensions of medication adherence serves to signify the interconnectivity between the dimensions, an important aspect of medication adherence supported by a number of conceptual frameworks11, 42, 66, 85 but were missing or not fully considered in others.50, 69, 115”

    From An Adaptable Framework for Factors Contributing to Medication Adherence: Results from a Systematic Review of 102 Conceptual Frameworks (2021) · cites this paper as [11]

    The Results section (‘Conceptual Model of MA in Older Adults with HBP’; page unavailable) describes relationships among factors in this paper’s model, including indirect effects through personal factors. The Introduction describes that model as having four ecological dimensions, not the five WHO dimensions. The paper therefore supports the importance of connections among adherence factors, but not the claim specifically about interconnectivity among the five WHO dimensions. (LLM, conf=0.84)

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  • These theories often ignore the effect of healthcare system- and healthcare team-related factors on patient behavior towards medication adherence.

    “While these theories are helpful in understanding the contribution of patient-related factors and community or environment in medication adherence, they often ignore the effect of healthcare system– and healthcare team–related factors on patient behavior towards medication adherence.11”

    From An Adaptable Framework for Factors Contributing to Medication Adherence: Results from a Systematic Review of 102 Conceptual Frameworks (2021) · cites this paper as [11]

  • Many conceptual models have been developed to help understand the factors contributing to medication adherence in specific patient groups and/or for specific disease conditions.

    “Many conceptual models have been developed to help understand the factors contributing to medication adherence in specific patient groups and/or for specific disease conditions.10–12”

    From An Adaptable Framework for Factors Contributing to Medication Adherence: Results from a Systematic Review of 102 Conceptual Frameworks (2021) · cites this paper as [11]

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Cited by

Sorted by citations

Authors
Oori, M. J., Mohammadi, F., Norouzi, K., Fallahi-Khoshknab, M., & Ebadi, A.
Affiliations
  • Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • Associate Professor of Iranian Research Center on Aging, Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • Baqiyatallah University of Medical Sciences (IR)
ORCID
Ebadi, Abbas
Venue
Current Hypertension Reviews
Publisher
Bentham Science Publishers Ltd.
Published
2019-05-29
Volume
15
Issue
2
Pages
85-92
ISSN
1573-4021 (ISSN-L)
DOI
10.2174/1573402114666181022152313
PMC
PMC6635648
OpenAlex
W2898432835
Cited by
19
References
3
Citations by year
2026: 3 · 2025: 2 · 2024: 5 · 2023: 2 · 2022: 4 · 2021: 3
FWCI
0.16
Type
journal article
Language
en
Open access
Licence
Locations
  • Current Hypertension Reviews (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
University of Social Welfare and Rehabilitation Sciences (IR.USWR.REC.1396.202)
Topics
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
medication adherence, hypertension, older adults, conceptual model, ecological approach, predictors of adherence, personal factors, interpersonal factors, organizational factors, social factors, antihypertensive drugs
MeSH terms
Aged, Antihypertensive Agents, Blood Pressure, Humans, Hypertension, Medication Adherence

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