IIntegrative Strategy for Improving Hypertension Medication Adherence Based on Social Determinants of Health and Health Philosophy

Andis Triyanto; Bambang Budi Raharjo

doi:10.14710/jpki.21.3.244-250

DOI: https://doi.org/10.14710/jpki.21.3.244-250

IIntegrative Strategy for Improving Hypertension Medication Adherence Based on Social Determinants of Health and Health Philosophy

*Andis Triyanto - UNNES Semarang, Indonesia

Bambang Budi Raharjo - Faculty of Medicine, Universitas Negeri Semarang, Indonesia, Indonesia

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

BibTex Citation Data :

@article{JPKI84006,
    author = {Andis Triyanto and Bambang Raharjo},
    title = {IIntegrative Strategy for Improving Hypertension Medication Adherence Based on Social Determinants of Health and Health Philosophy},
    journal = {Jurnal Promosi Kesehatan Indonesia},
  volume = {21},
    number = {3},
    year = {2026},
    keywords = {Social determinants of health, Health philosophy, Hypertension, Patient autonomy},
    abstract = {   Background:    Hypertension remains a major public health problem in Indonesia, with a steadily increasing prevalence and a significant contribution to cardiovascular morbidity and mortality. One of the main challenges in its management is low patient adherence to long-term treatment. This study aims to develop an integrative strategic model to improve adherence to hypertension treatment by combining the perspectives of social determinants of health and health philosophy, which are still rarely integrated in public health studies.     Method:    This study employed a mixed-methods explanatory sequential design. Quantitative data were collected from 250 hypertensive patients using structured questionnaires and analyzed using multiple linear regression to identify determinants of medication adherence. Subsequently, 20 purposively selected participants were interviewed in-depth, and qualitative data were analyzed using thematic analysis. Significant quantitative determinants were integrated into an adherence model, and its performance     Result:    The results showed that treatment adherence was significantly influenced by health literacy (β = 0.41; p < 0.001), family support (β = 0.32; p < 0.01), quality of healthcare services (β = 0.29; p < 0.05), and patient autonomy awareness (β = 0.27; p < 0.05). The developed integrative model demonstrated higher predictive power (R  = 0.62) compared to conventional sociodemographic-based models (R² = 0.38). Qualitative findings further confirmed that reflective awareness and individual moral responsibility play important roles in shaping long-term adherence. This integrative approach has the potential to improve long-term medication adherence among patients with hypertension through the integration of health literacy, family support, healthcare service quality, and patient autonomy.  },
   issn = {2620-4053},   pages = {244--250}  doi = {10.14710/jpki.21.3.244-250},
    url = {https://ejournal.undip.ac.id/index.php/jpki/article/view/84006}
}

Citation Format:

Abstract

Background: Hypertension remains a major public health problem in Indonesia, with a steadily increasing prevalence and a significant contribution to cardiovascular morbidity and mortality. One of the main challenges in its management is low patient adherence to long-term treatment. This study aims to develop an integrative strategic model to improve adherence to hypertension treatment by combining the perspectives of social determinants of health and health philosophy, which are still rarely integrated in public health studies.

Method: This study employed a mixed-methods explanatory sequential design. Quantitative data were collected from 250 hypertensive patients using structured questionnaires and analyzed using multiple linear regression to identify determinants of medication adherence. Subsequently, 20 purposively selected participants were interviewed in-depth, and qualitative data were analyzed using thematic analysis. Significant quantitative determinants were integrated into an adherence model, and its performance

Result: The results showed that treatment adherence was significantly influenced by health literacy (β = 0.41; p < 0.001), family support (β = 0.32; p < 0.01), quality of healthcare services (β = 0.29; p < 0.05), and patient autonomy awareness (β = 0.27; p < 0.05). The developed integrative model demonstrated higher predictive power (R= 0.62) compared to conventional sociodemographic-based models (R² = 0.38). Qualitative findings further confirmed that reflective awareness and individual moral responsibility play important roles in shaping long-term adherence. This integrative approach has the potential to improve long-term medication adherence among patients with hypertension through the integration of health literacy, family support, healthcare service quality, and patient autonomy.

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Keywords: Social determinants of health, Health philosophy, Hypertension, Patient autonomy

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Section: Research Article

Language : EN

In Vol 21 No 3: July 2026

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