Modifiable Factors Associated with Non-adherence to Antihypertensive or Antihyperlipidemic Drugs Are Dissimilar: a Multicenter Study Among Patients with Diabetes in Indonesia

Sofa D Alfian*, Nurul Annisa, Fajriansyah Fajriansyah, Dyah A Perwitasari, Rizky Abdulah, Eelko Hak, Petra Denig

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background To develop targeted and tailored interventions for addressing medication non-adherence, it is important to identify underlying factors. Objective To identify factors associated with non-adherence as well as subtypes of non-adherence to antihypertensive or antihyperlipidemic drugs among patients with type 2 diabetes in Indonesia. Design An observational multicenter cross-sectional survey. Participants Patients with type 2 diabetes using either antihypertensive or antihyperlipidemic drugs in four regions in Indonesia. Main Measures Non-adherence and its subtypes of intentional and unintentional non-adherence were assessed using the Medication Adherence Report Scale. Necessity and concern beliefs were assessed with the Beliefs about Medicines Questionnaire. We applied binary and multinomial logistic regression to assess associations of medication beliefs, sociodemographic factors, and clinical-related factors to non-adherence and report odds ratios (OR) with 95% confidence intervals (CI). Key Results Of 571 participating patients (response rate 97%), 45.5% and 52.7% were non-adherent to antihypertensive and antihyperlipidemic drugs, respectively. Older age was associated with non-adherence to antihypertensive drugs (60-69 years) (OR, 5.65; 95% CI, 2.68-11.92), while higher necessity beliefs (OR, 0.92; 95% CI, 0.88-0.95) were associated with less non-adherence. Factors associated with non-adherence to antihyperlipidemic drugs were female gender (OR, 1.84; 95% CI, 1.03-3.27) and higher concern beliefs (OR, 1.10; 95% CI, 1.03-1.18), while higher necessity beliefs (OR, 0.89; 95% CI, 0.83-0.96) were associated with less non-adherence. Conclusions The main factors associated with non-adherence to antihypertensive and antihyperlipidemic drugs are modifiable. In general, beliefs about the necessity of the drug are important but for antihyperlipidemic drugs concerns are important as well. Healthcare providers should pay attention to identify and address medication beliefs during patient counselling.

Original languageEnglish
Pages (from-to)2897-2906
Number of pages10
JournalJournal of General Internal Medicine
Issue number10
Early online date16-Apr-2020
Publication statusPublished - 16-Apr-2020


  • medication non-adherence
  • medication beliefs
  • diabetes mellitus
  • blood pressure-lowering medication
  • lipid-lowering medication

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