Noncommunicable diseases (NCDs), including cancer, diabetes, hypertension, cardiovascular diseases, and chronic respiratory conditions, are the leading global causes of morbidity and mortality. Depression frequently co-occurs with these conditions, and may significantly reduce medication adherence, thereby worsening health outcomes. This narrative review examines the relationship between depression and medication adherence in patients with NCDs. It also highlights the current challenges in managing this comorbidity and explores potential strategies for improving adherence outcomes. Most studies have reported a significant negative association between depression and medication adherence in diverse NCD populations. Depressive symptoms impair motivation, memory, and executive functioning, which are essential for the maintenance of treatment regimens. However, inconsistencies across studies have been observed due to variability in the measurement of depression and adherence, study design, and control of confounding factors. Despite evidence from high-income countries supporting integrated care models such as collaborative care and cognitive behavioral therapy, implementation of these models in low- and middle-income countries remains limited. Emerging strategies, including task shifting, digital health tools (e.g., mobile health apps and telemedicine), and community-based support systems, offer promising avenues for intervention. Addressing this issue requires integrated and scalable interventions tailored to local contexts. Future research should focus on longitudinal and interventional studies, particularly in resource-limited settings, to inform policies and practices.
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Health behaviors, lifestyle factors, and healthcare challenges in family medicine: a comprehensive review of recent evidence from Asian populations Joung Sik Son Korean Journal of Family Medicine.2025; 46(4): 215. CrossRef
Background Maintaining a usual source of care (USC), which is crucial for primary healthcare, encompasses initial contact, comprehensive services, coordinated care, and ongoing support. However, limited research exists on the relationship between USC and medication adherence in patients with hypertension. This study aimed to investigate the association between USC and medication adherence among patients with hypertension.
Methods Data from the 2nd Korea Health Panel Survey 2020 were analyzed. The final sample consisted of 3,318 participants aged 19 years or older diagnosed with hypertension. USC was categorized into three groups: no USC, place only (without a regular doctor), and regular doctor. Medication adherence was assessed using detailed items (dose, frequency, time, no stop) and a 4-point Likert scale. A logistic regression analysis was conducted with control for relevant variables.
Results Compared to the no USC group, the regular doctor group had significantly higher odds ratios (ORs) for overall perfect/high medication adherence rates: 1.70 (95% confidence interval [CI], 1.42–2.03) and 1.59 (95% CI, 1.14–2.20). Similar results were observed for each adherence item, including prefect dose (OR, 2.14; 95% CI, 1.73– 2.63), frequency (OR, 1.87; 95% CI, 1.53–2.28), time (OR, 1.72; 95% CI, 1.43–2.07), and no stop (OR, 1.56; 95% CI, 1.09–2.23)/high frequency (OR, 2.47; 95% CI, 1.21–5.01), time (OR, 2.30; 95% CI, 1.19–4.44). However, the place only group showed no significant differences in medication adherence except for perfect adherence to dose (OR, 1.35; 95% CI, 1.06–1.71).
Conclusion These findings provide evidence supporting the need for healthcare policies that encourage having a regular doctor in South Korea, which has a healthcare system with limited primary care.
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Background This study aimed to examine the relationship between patient experience and medication compliance of patients with dyslipidemia.
Methods Based on data from the Korea National Health and Nutrition Examination Survey in 2015, the study examined 764 patients treated with dyslipidemia medication. Subjects who responded to the question “Do you currently take medication to lower your blood cholesterol?” with “daily taking” were categorized as the compliant group, and the remaining subjects were classified under the non-compliant group. The patient experience survey included four indicators, in which subjects were divided into groups with a positive and negative patient experience. Data on sociodemographic factors, health-related behaviors, and self-reported comorbid conditions were also collected.
Results After adjusting the variables, the group with a positive response for the patient experience indicator “doctor spends enough time with the patient during consultation” was 1.89 times more compliant than the group with a negative response (95% confidence interval [CI], 1.03–3.48; P=0.04). For the indicator “doctor provides easy-to-understand explanations,” the group that showed a positive response was 2.74 times more compliant than the group with a negative response (95% CI, 1.39–5.39; P=0.004). For the indicator “doctor involves patients in decisions about care or treatment,” the group that showed a positive response was 2.07 times more compliant than the group with a negative response (95% CI, 1.02–4.22; P=0.04). However, for the indicator “doctor provides the patient a chance to ask questions about treatment,” positive patient experience had no significant association with medication compliance (95% CI, 0.77–2.36; P=0.30).
Conclusion Building a good doctor-patient relationship with positive patient experiences can result in better outcomes for patient care through high medication compliance.
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Insights into medication adherence among Jordanian patients with dyslipidemia: evaluating health literacy, well-being, and doctor-patient communication Muna Barakat, Samar Thiab, Shaymaa B. Abdulrazzaq, Marah Al-Jamal, Fotoh AlHariri, Rakan Bassam Ammari, Sara Mansour, Sami El Khatib, Souheil Hallit, Basile Hosseini, Diana Malaeb, Hassan Hosseini Journal of Pharmaceutical Policy and Practice.2024;[Epub] CrossRef
Background This study aimed to estimate the prevalence of and determine the factors associated with antihypertensive medication (A-HTNM) non-adherence among hypertension care seekers attending primary health clinics in the Gaza Strip.
Methods A cross-sectional survey was conducted as the recruitment phase of a clustered randomized controlled trial including 538 participants. The participants were randomly selected from 10 primary health care centers by two-stage cluster random sampling. A structured questionnaire was used to collect data through face-to-face interview. The questionnaire was developed based on the World Health Organization determinants for medication non-adherence and the Health Belief Model. The main outcomes of this study were the prevalences of A-HTNM non-adherence and its associated factors. Adherence status was assessed using the eight-item Morisky Self-Report Medication Adherence Scale. Data were analyzed by STATA ver. 14.0 (Stata Corp., College Station, TX, USA) using a standard complex survey, accounting for unresponsiveness and the clustering sampling approach.
Results The overall prevalence of A-HTNM non-adherence was 65.8% (95% confidence interval [CI], 59.2–71.8). Among all studied predictors, only self-efficacy of participants (odds ratio [OR], 3.8; 95% CI, 1.79–2.84) and social support (OR, 2.26; 95% CI, 2.82–5.11) remained significantly associated with A-HTNM non-adherence after adjusting for age, education level, number and frequency of A-HTNM doses per day, and comorbidities.
Conclusion The high prevalence of non-adherence highlights the need for serious intervention to enhance the adherence rate among hypertension patients. The associated factors can be considered when developing appropriate interventions.
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Background Uncontrolled blood pressure (BP) is relatively common despite treatment with antihypertensive medication. This study aimed to investigate factors associated with uncontrolled systolic BP (SBP) and diastolic BP (DBP) separately in hypertensive patients with high medication adherence in Korea.
Methods This population-based cross-sectional study included 3,236 participants in the Korea National Health and Nutrition Examination Survey from 2013 to 2015. Hypertensive patients with high medication adherence were defined when they stated that they were taking antihypertensive medication daily. “Uncontrolled SBP and DBP” were defined as SBP ≥140 mm Hg and DBP ≥90 mm Hg, respectively. Data were analyzed using logistic regression to determine the association between uncontrolled SBP or DBP and various factors.
Results The prevalence of uncontrolled SBP and uncontrolled DBP was 23.3%, and 9.0%, respectively. In multivariate analysis, uncontrolled SBP was positively associated with older age, female sex, blue-collar occupation or no work (vs. white-collar), presence of a spouse, short sleep duration, frequent heavy alcohol drinking, longer hypertension duration, diabetes, stroke, and missing antihypertensive medication on the examination day, but negatively associated with high stress. Uncontrolled DBP was positively associated with frequent heavy alcohol drinking, but negatively associated with older age, blue-collar occupation or no work (vs. white-collar), and diabetes.
Conclusion After excluding low medication adherence, we identified various factors associated with uncontrolled SBP or DBP in Korean adults with treated hypertension. There were differences between factors associated with uncontrolled SBP or DBP. Separate analysis of SBP and DBP may help understand the factors involved in BP control.
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Results Mean changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) and MAS differed significantly within groups. The home blood pressure monitoring group showed greater mean changes (SBP 17.6 mm Hg, DBP 9.5 mm Hg, MAS 1.5 vs. SBP 14.3 mm Hg, DBP 6.4 mm Hg, MAS 1.3), while between group comparisons showed no significant differences across all variables. The adjusted mean difference for mean SBP was 4.74 (95% confidence interval [CI], -0.65 to 10.13 mm Hg; P=0.084), mean DBP was 1.41 (95% CI, -2.01 to 4.82 mm Hg; P=0.415), and mean MAS was 0.05 (95% CI, -0.29 to 0.40 mm Hg; P=0.768).
Conclusion Short-term home blood pressure monitoring significantly reduced office blood pressure and improved medication adherence, albeit similarly to standard care.
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Background Hypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication.
Methods From August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable.
Results Of the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ≥65 years, exercise, treatment in a metropolitan-located hospital, being on ≥2 classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication.
Conclusion Multiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.
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Association of Total Medication Burden With Intensive and Standard Blood Pressure Control and Clinical Outcomes: A Secondary Analysis of SPRINT Catherine G. Derington, Tyler H. Gums, Adam P. Bress, Jennifer S. Herrick, Tom H. Greene, Andrew E. Moran, William S. Weintraub, Ian M. Kronish, Donald E. Morisky, Katy E. Trinkley, Joseph J. Saseen, Kristi Reynolds, Jeffrey T. Bates, Dan R. Berlowitz, Ta Hypertension.2019; 74(2): 267. CrossRef
Association Between Medication Literacy and Medication Adherence Among Patients With Hypertension Shuangjiao Shi, Zhiying Shen, Yinglong Duan, Siqing Ding, Zhuqing Zhong Frontiers in Pharmacology.2019;[Epub] CrossRef
Assessment of adherence to drug treatment and affecting factors among hypertensive patients Burkay YAKAR, Asli AZAKOGLU KARACA, Erhan ONALAN Family Practice and Palliative Care.2019; 4(3): 89. CrossRef
Medication Adherence in Korean Hypertensive Patients Young Gyu Cho Korean Journal of Family Medicine.2018; 39(6): 323. CrossRef
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