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Abstract

The aging population has led to more elderly with hypertension and multiple comorbidities. These patients often require several medications, resulting in polypharmacy, which can cause adverse outcomes and poor adherence. This study aimed to assessing the impact of polypharmacy on medication adherence among elderly patients with hypertension. This study employed a cross-sectional design and was conducted at two primary healthcare centers, in East Java, Indonesia, from February to June 2024. Participants were patients aged ≥60 years who had received antihypertensive therapy for at least three months. Medication adherence was assessed using pill counts, while polypharmacy was categorized as minor (1–3 drugs), moderate (4–5 drugs), and major (>5 drugs). Data were analyzed using Spearman’s rank correlation. Among the 212 respondents, most were female 159 (75%) and aged 60–69 years 169 (80%). Diabetes mellitus 97 (45.75%) and dyslipidemia 16 (7.55%) were the most common comorbidities. Amlodipine was the most frequently prescribed drug. More than half of the patients 109 (51.42%) received 4–5 medications, and 45 (21.23%) were non-adherent. Spearman’s analysis revealed a significant correlation between polypharmacy and adherence (p= 0.019). Polypharmacy was highly prevalent among elderly hypertensive patients and showed a significant association with poor adherence, emphasizing the importance of optimizing prescribing practices, reducing unnecessary medication use, and promoting single-pill combinations to improve adherence and clinical outcomes in primary care settings‎.

Keywords: Adherence, Elderly, Hypertension, Pill count, Polypharmacy

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