Exploring the experience of medication adherence among older people with hypertension: a qualitative study from a tertiary care hospital, Sri Lanka

Abstract

Hypertension is one of the leading risk factors for cardiovascular diseases, contributing significantly to global mortality rates. The older population is particularly vulnerable to hypertension and its complications. Medication adherence is essential for minimizing these risks, reducing adverse reactions and improving health outcomes, thereby reducing the burden on the healthcare system. This study aimed to explore experiences on medication adherence among older people with hypertension at a tertiary care hospital in Sri Lanka. An exploratory qualitative study was conducted among 15 individuals who had a history of uncontrolled blood pressure for more than a year and attending the hypertension clinic at Teaching Hospital Peradeniya, Sri Lanka. In-depth interviews were conducted using a semi-structured interview guide. Participants were selected using purposive sampling until data saturation was achieved. Interviews were audio recorded, transcribed verbatim, and analyzed using inductive thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) guidelines were followed when presenting the results. Three main themes emerged: (a) Knowledge and awareness, (b) Barriers to medication adherence and (c) Support systems in medication adherence. Under Knowledge and awareness, Sub-themes included early detection awareness, knowledge of disease and therapeutic approaches, self-medication management and monitoring. The theme barriers to medication adherence included side effects, polypharmacy, psychological impacts, lifestyle and behavioral factors, forgetfulness, motivational drivers, and personal affairs. Finally, support systems in medication adherence included peer influence, family support, accessibility to medical care, perceived quality of care and health education by the institution. This study highlights the importance of knowledge and awareness in promoting medication adherence. It emphasizes that the gaps in disease understanding contribute to poor health outcomes. Key barriers and weak support systems further hindered medication adherence. Patient-centered interventions and enhanced support mechanisms are crucial for improving medication adherence in the elderly population.