A Nomogram-based Analysis on Medication Adherence of Hypertensive Patients in China

In order to analyze the influencing factors of medication adherence in Chinese hypertensive patients, a nomogram of medication adherence in hypertensive patients was constructed in this paper, which may provide a foundation for the establishment of a simple method for predicting medication adherence in hypertensive patients.

We enrolled 297 hypertensive patients in a tertiary care hospital in Wuhu City. Medication adherence was assessed using the 4-item Medication Adherence Scale. Patients were categorized into the adherence group and poor medication adherence group based on their scores. We used logistic regression to identify factors influencing medication adherence. The predictors were analyzed by nomogram method using R software. Its effectiveness was assessed by the area under the curve (AUC) of the receiver operating characteristic curve (ROC) and the calibration curve to evaluate its discriminatory power and accuracy.

Of the 297 patients, 111 (37.4%) had good medication adherence, and 186 (62.6%) had poor medication adherence. In the group with good medication adherence, there were 52 (46.8%) men and 48 (43.3%) persons aged ≤65 years; in the group with poor medication adherence, there were 101 (54.3%) men and 92 (49.4%) persons aged 65-80 years. Place of residence, Acceptance of the disease, Satisfaction with family functioning, Frailty, and E-health literacy were factors influencing adherence to medication in hypertensive patients (p < .05); The predictors were incorporated into the R software to establish a nomogram of medication adherence in hypertensive patients, and its test showed an AUC of .83 (95% CI: 0.79-0.88); Hosmer-Lemeshow goodness-of-fit test showed χ² = 4.78, p = .78, which indicated that the model had a high degree of differentiation and precision.

Overall, Chinese hypertensive patients had poor medication adherence. Medication adherence was better among hypertensive patients who lived in a city, had higher disease acceptance, had more satisfactory family functioning, were not physically frail, and had higher e-health literacy. The established nomogram has a good predictive value for medication adherence in hypertensive patients, reduces the medical burden on society and families, and provides a reference for clinical caregivers.