Effects of a Health Belief Model–Based Program on Medication Perception, Medication Adherence, and Blood Pressure among Older Adults with Hypertension.

Authors

  • Wanna Kulhakul -
  • Kanitta Wongsod -
  • Phasuk Mankhong -

Keywords:

medication perception, , medication adherence, hypertension, older adults, Health Belief Model

Abstract

      This quasi-experimental study aimed to examine the effects of a Health Belief Model–based program on medication perception, medication adherence, and blood pressure among older adults with hypertension. A two-group pretest–posttest design was employed. The sample consisted of 60 older adults, selected using purposive sampling and equally assigned to an experimental group and a control group (n = 30 each) using time-based allocation. The research instruments included the intervention program, a medication perception questionnaire a medication adherence questionnaire and blood pressure records. Data were analyzed using descriptive statistics, paired t-test, independent t-test, and Pearson’s correlation coefficient.

      The results showed that, after the intervention, the experimental group demonstrated significantly higher medication perception and medication adherence scores compared with their pretest scores (p < .05) and those of the control group (p < .01). In addition, systolic and diastolic blood pressure levels were significantly reduced compared with the control group (p < .01). Medication perception was positively correlated with medication adherence (r = .68, p < .01) and negatively correlated with blood pressure levels (r = −.52, p < .01). Medication adherence was also negatively correlated with blood pressure levels (r = −.55, p < .01).  

References

World Health Organization. (2023). Hypertension. https://www.who.int/news-room/fact-sheets/detail/hypertension

Aekplakorn W, Puckcharern H, Thaikla K, Satheannoppakao W, Vathesatogkit P. Thai National Health Examination Survey VI. Nonthaburi: Health Systems Research Institute; 2021.

Burnier, M., & Egan, B. M. Adherence in hypertension. Circulation Research. (2019). 124(7), 1124–1140. https://doi.org/10.1161/CIRCRESAHA.118.313220

สำนักงานสาธารณสุขจังหวัดสิงห์บุรี. รายงานสถานการณ์โรคความดันโลหิตสูง จังหวัดสิงห์บุรี. สิงห์บุรี: สำนักงานสาธารณสุขจังหวัดสิงห์บุรี; 2567.

ศูนย์วิจัยและประเมินเทคโนโลยีทางการแพทย์. รายงานสถานการณ์โรคความดันโลหิตสูงในประเทศไทย. นนทบุรี: กรมการแพทย์ กระทรวงสาธารณสุข; 2563. Available from: https://www.dms.go.th

Becker, M. H. The health belief model and personal health behavior. Health Education Monographs. 1974;2, 324–473.

Rosenstock, I. M. Historical origins of the health belief model. Health Education Monographs. 1974;2(4), 328–335.

Lee JK, Grace KA, Taylor AJ. Effect of a pharmacy care program on medication adherence and persistence, blood pressure, and low-density lipoprotein cholesterol: A randomized controlled trial. JAMA. 2006;296(21):2563-2571.

Tam, H. L., Wong, E. M. L., & Cheung, K. Effectiveness of educational interventions on adherence to lifestyle modifications among hypertensive patients. International Journal of Environmental Research and Public Health. 2020;17(7), 2513.

Al-Noumani SM, Al-Harrasi M, Jose J, Al-Naamani Z, Panchatcharam SM. Educational interventions to improve medication adherence in patients with chronic diseases. J Nurs Educ Pract. 2020;10(3):45-53. DOI: 10.5430/jnep.v10n3p45

Islam, M. T., Arafat, S. M., Chowdhury, A., Orchi, K., Sultana, S., Bushra, T., Islam, M. R., Fatema, K., Khan, M. M. H., & Haque, M. A. Role of the Health Belief Model in the management of hypertension: A systematic review. Cureus. 2025;17(10), e94139. https://doi.org/10.7759/cureus.94139

Bandura A. Self-efficacy: The exercise of control. New York: W.H. Freeman; 1997.

Rimer BK, Glanz K. Theory at a glance: A guide for health promotion practice. 2nd ed. Bethesda (MD): National Cancer Institute; 2005. Available from: https://cancercontrol.cancer.gov/brp/research/theories_project/theory.pdf

Thyer BA. The handbook of social work research methods. 3rd ed. Thousand Oaks (CA): Sage Publications; 2020. doi:10.4135/9781544364902.

Best JW, Kahn JV. Research in education. 10th ed. Boston: Pearson Education; 2017.

Wong MCS, Mercer S, Lam AT, et al. The effectiveness of health education programs for hypertension control: A systematic review. BMC Public Health. 2020;20:456. doi:10.1186/s12889-020-08628-5.

Kim SJ, Shin J, Park JB, Kim KI. Medication adherence and blood pressure control among hypertensive patients. Hypertension Res. 2018;41(4):268-275.

Zhang Y, Li X, Wang Z, Chen H. Educational intervention for hypertension management: A systematic review and meta-analysis. Int J Nurs Stud. 2021;118:103913.

Ruppar TM, Cooper PS, Mehr DR, Delgado JM, Dunbar-Jacob JM. Medication adherence interventions improve heart disease mortality and readmission rates: Systematic review and meta-analysis. Drugs Aging. 2019;36(3):213-223. doi:10.1007/s40266-018-00607-4.

Abegaz TM, Shehab A, Gebreyohannes EA, Bhagavathula AS, Elnour AA. Nonadherence to antihypertensive drugs: A systematic review and meta-analysis. Medicine (Baltimore). 2017;96(4):e5641. doi:10.1097/MD.0000000000005641.

Marcum ZA, Sevick MA, Handler SM. Medication nonadherence: A diagnosable and treatable medical condition. Drugs Aging. 2017;34(3):191-201.

Liu X, Zhang Y, Fang S, Zhang J, Wang Y, Zhang Y. Medication adherence and blood pressure control among hypertensive patients. J Clin Hypertens (Greenwich). 2021;23(2):321–329. doi:10.1111/jch.14188.

Bosworth HB, Granger BB, Mendys P, Brindis R, Burkholder R, Czajkowski SM, et al. Medication adherence: A call for action. Am Heart J. 2011;162(3):412–424. doi:10.1016/j.ahj.2011.06.007.

Wongpakaran T, Wongpakaran N, Sirirak T. Illness perception and health behaviors among patients with chronic diseases. J Health Res. 2022;36(2):215-224. doi:10.1108/JHR-05-2021-0273., 118, 103913.

Downloads

Published

2026-06-30

How to Cite

Kulhakul, W., Wongsod, K., & Mankhong, P. (2026). Effects of a Health Belief Model–Based Program on Medication Perception, Medication Adherence, and Blood Pressure among Older Adults with Hypertension. Journal of Environmental Education Medical and Health, 11(2), 50–61. retrieved from https://so06.tci-thaijo.org/index.php/hej/article/view/296616