Dinamika Kepatuhan Terapi dan Kontrol Tekanan Darah: Analisis Komparatif antara Komunitas Hipertensi Baru dan Kronis

Abstract

Background: Hypertension is a chronic condition requiring long-term management. Medication adherence is widely recognized as a key determinant of blood pressure control; however, in clinical practice, not all adherent patients achieve optimal outcomes, suggesting the presence of an adherence outcome gap. Objective: This study aimed to examine the correlation between therapeutic adherence and the achievement of optimal blood pressure control and to compare patterns between newly diagnosed and chronic hypertensive patients in a community setting. Method: A cross-sectional study was conducted involving 62 purposively sampled hypertensive patients. Data collection involved assessing patient adherence through the Morisky Medication Adherence Scale (MMAS-8) and recording educational attainment. Additionally, physiological measurements were obtained, including blood pressure determination using a digital sphygmomanometer and the calculation of BMI. Data were analyzed using Chi-square tests followed by Structural Equation Modeling (SEM) to explore direct and indirect relationships among variables. Result: The Chi-square test demonstrated a significant association between medication adherence and blood pressure control (p<0.001), indicating that patients with higher adherence tended to have better-controlled blood pressure. Comparative analysis revealed that chronic hypertension was associated with lower medication adherence and poorer blood pressure control (OR=22.8; RR=2.56; p<0.001). Furthermore, Structural Equation Modeling (SEM) analysis showed that the duration of hypertension had a significant negative effect on medication adherence (β=-0.72; p< 0.001. Conclusion: Medication adherence contributes to blood pressure control but is not sufficient as a sole determinant. A multidimensional approach integrating behavioral, individual, and physiological factors is essential for effective hypertension management in community settings.