Skip to main content Skip to main navigation menu Skip to site footer

Cross sectional study: health literacy towards adherence to medication for hypertension patients

  • Nur Ainiyah ,
  • Chilyatiz Zahroh ,
  • Diah Retno Kusumawati ,
  • Siti Damawiyah ,
  • Erika Martining Wardani ,


Background: Most people with hypertension feel healthy and energetic; this situation is dangerous and can cause death in the community. Non-compliance is a complex phenomenon often occurring in health care, especially in hypertensive patients. Medication adherence is very important so that complications do not occur, but many hypertensive patients still do not comply with medication. This study aimed to analyze the correlation between health literacy and adherence to medication for hypertension patients in the COVID-19 pandemic era at Private Hospital Surabaya.

Methods: This research design was correlative analytic with a cross-sectional approach. This study's population was hypertensive patients treated at Hospital D with a simple random sampling of 74 people. The instruments used in this study were Health Literacy Scale (HLS-EU-Q16) to measure health literacy and adherence to medication by using Morisky Medication Adherence Scale (MMAS-8). The Rank Spearman test used data analysis to measure health literacy with medication adherence.

Results: The results showed a relationship between health literacy and adherence to medication for hypertension patients at Private Hospital Surabaya with a level (p=0.000).

Conclusion: Findings from the study suggest that improving health literacy important for support to be more responsible in hypertension medication.


  1. Hing M, Hoffman RM, Seleman J, Chibwana F, Kahn D, Moucheraud C.' Blood pressure can kill you tomorrow, but HIV gives you time': Illness perceptions and treatment experiences among Malawian individuals living with HIV and hypertension. Health Policy Plan. 2019;34(Supplement_2):ii36–44.
  2. Siantar RL, Simanjuntak FM, Aritonang TR. Efectiveness of Celery (Apium Graveolens) on Hppertension in The Elderly. Sci Midwifery. 2021;9(2):360–5.
  3. Neupane D, Gao Y, Feng Y, Matsushita K, Appel LJ. Estimation of the Global Gap in Clinic Visits for Hypertension Care between Patient Need and Physician Capacity. Hypertension. 2021;(September):779–86.
  4. Kemenkes RI. Hasil Riset Kesehatan Dasar Tahun 2018. Kementrian Kesehat RI. 2018;53(9):1689–99.
  5. Sukmaningtyas W, Utami T. Risk Factors of Hypertension in the Elderly. 2020;20(Icch 2019):215–21.
  6. Du S, Zhou Y, Fu C, Wang Y, Du X, Xie R. Health literacy and health outcomes in hypertension: an integrative review. Int J Nurs Sci. 2018;5(3):301–9.
  7. Zhang NJ, Terry A, McHorney CA. Impact of Health Literacy on Medication Adherence: A Systematic Review and Meta-analysis. Ann Pharmacother. 2014;48(6):741–51.
  8. Song J-J, Ma Z, Wang J, Chen L-X, Zhong J-C. Gender differences in hypertension. J Cardiovasc Transl Res. 2020;13:47–54.
  9. Biffi A, Rea F, Iannaccone T, Filippelli A, Mancia G, Corrao G. Sex differences in the adherence of antihypertensive drugs: A systematic review with meta-analyses. BMJ Open. 2020;10(7).
  10. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223–37. Available from:
  11. Chantkran W, Chaisakul J, Rangsin R, Mungthin M, Sakboonyarat B. Prevalence of and factors associated with stroke in hypertensive patients in Thailand from 2014 to 2018: A nationwide cross-sectional study. Sci Rep. 2021;11(1):1–12.
  12. Rampengan SH, Sunarto HJ. Hypertensive emergency: an overview of heart as target organ damage. Bali Med J. 2020;9(3):903–6.
  13. Baltabayeva M, Kodirova D. The need to provide the priority of spiritual and educational processes in the modern education system. Acad An Int Multidiscip Res J. 2022;12(1):423–7.
  14. Pazoki R, Dehghan A, Evangelou E, Warren H, Gao H, Caulfield M, et al. Genetic predisposition to high blood pressure and lifestyle factors: Associations with midlife blood pressure levels and cardiovascular events. Circulation. 2018;137(7):653–61.
  15. Akbarbegloo M, Sanaeefar M, Majid P, Mohammadzadeh M. Psychosocial care experiences of patients with COVID‐19 at home in Iran: A qualitative study. Health Soc Care Community. 2022;30(1):264–74.
  16. Stuart JJ, Tanz LJ, Missmer SA, Rimm EB, Spiegelman D, James-Todd TM, et al. Hypertensive disorders of pregnancy and maternal cardiovascular disease risk factor development: an observational cohort study. Ann Intern Med. 2018;169(4):224–32.
  17. Lestari ND, Anisa VN. The relationship between self efficacy and medication adherence in elderly with hypertension. Bali Med J. 2022;11(3):1660–5.
  18. Liu C, Wang D, Liu C, Jiang J, Wang X, Chen H, et al. What is the meaning of health literacy? A systematic review and qualitative synthesis. Fam Med community Heal. 2020;8(2).
  19. Nutbeam D, Lloyd JE. Understanding and responding to health literacy as a social determinant of health. Annu Rev Public Heal. 2021;42(1):159–73.
  20. Edyawati E, Asmaningrum N, Nur KRM. Relationship between the health literacy level with drug compliance among tuberculosis patients in Puskesmas of Ponorogo Regency. Artik Penelit J Keperawatan Sriwij. 2021;8(2):50–9.
  21. Marquez Contreras E, Marquez Rivero S, Rodriguez Garcia E, López-García-Ramos L, Carlos Pastoriza Vilas J, Baldonedo Suarez A, et al. Specific hypertension smartphone application to improve medication adherence in hypertension: a cluster-randomized trial. Curr Med Res Opin. 2019;35(1):167–73.
  22. Roustaei N, Hosayni H, Jokar S, Zinat motlagh F. Factors Related to Medication Adherence in Hypertensive Patients in the Iranian Population. J Clin Care Ski. 2022;3(1):13–8.
  23. Al Zahrani S, Eid Alosaimi M, Alamrim AA, Alotaibi M, Almatar EA, Almanea BA. Association between knowledge and drug adherence in patients with hypertension in Saudi Arabia. Arch Pharm Pr. 2019;10(3):71–6.
  24. Qu Z, Parry M, Liu F, Wen X, Li J, Zhang Y, et al. Self-management and blood pressure control in China: a community-based multicentre cross-sectional study. BMJ Open. 2019;9(3):e025819.
  25. Harding BN, Hawley CN, Kalinowski J, Sims M, Muntner P, Young BA, et al. Relationship between social support and incident hypertension in the Jackson Heart Study: a cohort study. BMJ Open. 2022;12(3):e054812.
  26. Maytasari S, Sartika RAD. Family, Social, and Health Workers Support with Complience Behaviour to Patients with Hypertension in Bogor, Indonesia. J PROMKES. 2020;8(2):146.
  27. Coskun S, Bagcivan G. Associated factors with treatment adherence of patients diagnosed with chronic disease: Relationship with health literacy. Appl Nurs Res. 2021;57(December 2019):151368.
  28. Tavakoly Sany SB, Behzhad F, Ferns G, Peyman N. Communication skills training for physicians improves health literacy and medical outcomes among patients with hypertension: a randomized controlled trial. BMC Health Serv Res. 2020;20:1–10.

How to Cite

Ainiyah, N., Zahroh, C., Kusumawati, D. R., Damawiyah, S., & Wardani, E. M. (2023). Cross sectional study: health literacy towards adherence to medication for hypertension patients. Bali Medical Journal, 12(3), 2917–2921.




Search Panel

Nur Ainiyah
Google Scholar
BMJ Journal

Chilyatiz Zahroh
Google Scholar
BMJ Journal

Diah Retno Kusumawati
Google Scholar
BMJ Journal

Siti Damawiyah
Google Scholar
BMJ Journal

Erika Martining Wardani
Google Scholar
BMJ Journal