Objective  To explore the changes in medication adherence of community dwelling hypertensive patients in six provinces in China, and analyze the influencing factors.

Methods  Community dwelling hypertensive patients attending 7 county-level community hospitals in 6 provinces in China were selected to undertake a health promotion program consisting of various health management interventions such as use of chronic disease pharmacies, hypertension clinics and drug dispensing services. Descriptive statistics were used to analyze the levels of medication adherence before after the hypertension health promotion program. Univariate analysis and logistic regression were used to analyze the factors that influenced patients' medication adherence. 

Results  A total of 715 hypertension patients who completed the follow-up survey were included in the study. The follow up survey showed that patients' medication adherence increased by 16.2% (P<0.001) compared with the baseline survey. Among them, the adherence of patients over 65 years old and patients using the new rural medical scheme increased by 20.6% and 21.7%, respectively. Patients with an annual family income of more than 30,000 yuan, Patients with medical insurance for urban residents, those having complications and self-care ability had higher medication compliance. 

Conclusion  The medication adherence of patients with hypertension in the survey area has been significantly improved, but there are differences in the degree of improvement among different populations. It is recommended that the government should take effective measures to increase the level of the new rural cooperative medical scheme, increase knowledge promotion activities about the prevention and treatment of hypertension for patients without comorbidities in order to improve the status of medication adherence in hypertensive patients.

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