THE ROLE OF MEDICATION ADHERENCE, SELF-CARE, AND SELF-EFFICACY IN ACHIEVING OPTIMAL BLOOD PRESSURE CONTROL AMONG HYPERTENSIVE PATIENTS IN PUNJAB

Abstract

Background: Hypertension remains a leading public health challenge in Pakistan, where poor medication adherence and inadequate self-care contribute to uncontrolled blood pressure. This study assessed the role of medication adherence, self-care, and self-efficacy in blood pressure control among hypertensive patients. Materials & Methods: A cross-sectional study was conducted at Lahore General Hospital and Jinnah Hospital, Lahore, including 420 hypertensive patients. Data were collected using structured questionnaires covering socio-demographic factors, the Girerd Adherence Scale, the Self-Care of Hypertension Inventory, and the Self-Efficacy for Managing Chronic Disease Scale. Blood pressure was measured clinically, with uncontrolled BP defined as ≥140/90 mmHg. Results: Among 420 hypertensive patients, 33.3% had high adherence, 45.2% moderate adherence, and 21.5% low adherence, with adherence significantly associated with knowledge (r = 0.22, p < 0.001), self-care maintenance (r = 0.34, p < 0.001), and self-efficacy (r = 0.29, p < 0.001). Patients taking ≥3 antihypertensive pills/day (OR = 1.92–2.61, p < 0.01) and those reporting side effects (OR = 1.81, p = 0.001) were more likely to show poor adherence, while controlled blood pressure reduced the odds of low adherence by 63% (OR = 0.37, p < 0.001). Conclusion: The study concludes that medication adherence among hypertensive patients in Punjab is significantly influenced by pill burden, side effects, knowledge, self-care, and self-efficacy, highlighting the need for targeted interventions to improve blood pressure control