Frailty and medication adherence among older adult patients with hypertension: a moderated mediation model

作者：Anshi Wang, Jingjing Wan, Lijun Zhu, Weiwei Chang, Liying Wen, Xiubin Tao, Yuelong Jin · 发表于：Frontiers in Public Health · 年份：2023 · DOI：10.3389/fpubh.2023.1283416 · 被引用次数：12 · 研究领域：Medication Adherence and Compliance、Pharmaceutical Practices and Patient Outcomes、Blood Pressure and Hypertension Studies

Objective Medication adherence has a critical impact on the well-being of older adult patients with hypertension. As such, the current study aimed to investigate the mediating role of health literacy between frailty and medication adherence and the moderating role of educational level. Methods This cross-sectional study included patients admitted to the geriatric unit of a hospital. Participants were interviewed using the four-item Morisky Medication Adherence Scale, the Frailty Phenotype Scale, and the Health Literacy Management Scale. Spearman’s correlation coefficients were used to assess the association between variables. Mediation and moderated mediation analyses were performed using Process version 4.1 via Model 4 and 14, respectively. Results Data from 388 participants were analyzed. The median (IQR [P 25 –P 75 ]) score for medication adherence was 4.00 (2.00–4.00). Results revealed that after controlling for age, sex, hypertension complication(s) and body mass index, frailty significantly contributed to medication adherence (β total −0.236 [95% confidence interval (CI) −0.333 to −0.140]). Medication adherence was influenced by frailty (β direct −0.192 [95% CI −0.284 to −0.099]) both directly and indirectly through health literacy (β indirect −0.044 [95% CI −0.077 to −0.014]). Educational level moderated the pathway mediated by health literacy; more specifically, the conditional indirect effect between frailty and medication adherence was significant among older adult ...