Empowerment Education to Increase Medication Adherence among Older People with Hypertension in Rural Areas in Indonesia

Abstract

Introduction: Empowerment is one of the effective approaches to promoting health behavior change and improving medication adherence in older people. Objective: We aimed to investigate the effectiveness of empowerment education in enhancing medication adherence among older people with hypertension. Methods: We used a quantitative approach with a quasi-experimental design. Older people with hypertension were randomly divided into an intervention group (n=22) that received empowerment education and a control group (n=22) that received standard care from the health center. The empowerment education program included information about hypertension, the importance of medication adherence, and techniques to manage hypertension through lifestyle modification. Medication adherence was measured using the Morisky Medication Adherence Scale-8 (MMAS-8) questionnaire. Statistical Analysis: To determine blood pressure and the category of compliance with taking geriatric medication from pre-, post-test, and follow-up in the intervention and control groups (within-subject), the Friedman Test post hoc and the Wilcoxon test were conducted. To determine the difference in blood pressure and the category of compliance with taking geriatric medication from pre, post-test, and follow-up between the intervention group and control group (between-subject), the Mann-Whitney Test was conducted, and to assess the strength of the effect size, the Cohen Effect Size test was applied. Results: Medication adherence in the intervention group showed a significant increase in adherence (p = 0.000) with a moderate effect size (d > 0.5). Meanwhile, medication adherence in the control group was not significant (p = 0.392). Conclusion: This intervention can be an option for nurses to help hypertensive older people improve their medication adherence and, in turn, their quality of life.

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