The role of medication timing and patient involvement in adherence to treatment for hypertension

Despite improvements in the effectiveness of medication for the treatment of hypertension, patient adherence to prescription regimens remains a challenge in clinical practice. This study examined the impact of two factors on improving medication adherence: medication timing (morning timing is considered as 06:00-10:00, and evening timing, as 20:00-midnight) and patient involvement. Following the STROBE guidelines, a cross-sectional survey design was undertaken at a university hospital between May and August 2023. Three hundred and four inpatients with a diagnosis of hypertension comprised the study sample. Data was gathered using the Control Preferences and Medication Adherence Report Scales. The results revealed that patients preferred to take a passive role in taking their medications (60.2%). However, more active patient participation in decision-making resulted from considering patients' daily routines (80.9%) and positive attitudes from healthcare providers during communication (69.4%). Regression analyses indicated that patient involvement (OR:5.649, 95%CI [2.528-12.622]), rather than medication timing (OR:1.052, 95%CI [0.591-1.875]), predicted treatment adherence. Shared decision-making improved adherence to medication regimes compared with passive acceptance (81.0% vs. 50.8%; p = .000). These findings underscore the significance of patient involvement. Given patients' preference for a paternalistic approach, in which healthcare providers make the decisions, often without patients' active involvement, promoting participation through strategies such as providing ample time for treatment discussions, offering information, and aligning treatment hours with patients' daily routines are promising approaches for enhancing adherence.