Objective  To explore the status of financial toxicity and its influencing factors among elderly hypertensive patients in rural areas, and to provide a reference for implementing effective interventions.

Methods  Using a random number table method, registered elderly hypertensive patients from a rural area of Zhuzhou, Hunan Province, were selected as the study subjects. The Incharge Financial Distress/Financial Well-being Scale, the Hypertensive Patients Self-management Behavior Scale, the Morisky Medication Adherence Scale, and the EuroQol Five Dimensions (EQ-5D) Health Questionnaire were used for assessment. A random forest model was employed to identify the importance of influencing factors, combined with Lasso regression and multiple linear regression to determine the main influencing factors.

Results  A total of 240 valid questionnaires were collected. The mean total financial toxicity score was (4.96 ± 1.46) points, with 64.6% of patients experiencing moderate financial toxicity and 22.5% experiencing high financial toxicity. The random forest model indicated that variables such as self-rated health status, medication adherence, and self-management behaviors significantly influenced financial toxicity. Multiple linear regression analysis further identified self-rated health status, medication adherence, self-management behaviors, hypertensive complications, daily exercise time, duration of having a family-contracted doctor, and serum total cholesterol as the main influencing factors for financial toxicity (P<0.05), collectively explaining 51.3% of the total variance.

Conclusion  The level of financial toxicity is relatively high among elderly hypertensive patients in rural Zhuzhou. Healthcare professionals should develop targeted intervention strategies based on the related influencing factors to improve patients' financial toxicity levels.

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