Background:
Medication adherence (MA) is the most important controlling factor of
high blood pressure (HBP). There are a few MA models, but they have not been successful in predicting
MA completely. Thus, this study aimed to expand a conceptual model of MA based on an
ecological approach.
Methods:
An integrative review of the literature based on theoretical and empirical studies was
completed. Data source comprised: Medline (including PubMed and Ovid), ISI, Embase, Google
scholar, and internal databases such as Magiran, Google, SID, and internal magazines. Primary
English and Persian language studies were collected from 1940 to 2018. The steps of study included:
(a) problem identification, (b) literature review and extracting studies, (c) appraising study
quality, (d) gathering data, (e) data analysis using the directed content analysis, (f) concluding.
Results:
Thirty-six articles were finally included and analyzed. After analysis, predictors of MA in
older adults with hypertension were categorized into personal, interpersonal, organizational, and
social factors. Although the personal factors have the most predictors in sub-categories of behavioral,
biological, psychological, knowledge, disease, and medication agents, social, organizational
and interpersonal factors can have indirect and important effects on elderly MA.
Conclusion:
There are many factors influencing MA of elderly with HBP. The personal factor has
the most predictors. The designed model of MA because of covering all predictor factors, can be
considered as a comprehensive MA model. It is suggested that future studies should select factors
for study from all levels of the model.
Activation of renin-angiotensin system in maintenance of high blood pressure in uncomplicated pheochromocytoma A case report.
