title: Determinants of Patient's Adherence to Hypertension Medications: Application of Health Belief Model Among Rural Patients.
abstract: BACKGROUND
  Hypertension is a major health problem in developing and developed countries, and its increasing epidemy is a serious warning to take more attention to this silent disease.
  
  
  OBJECTIVE
  This study was aimed to determine the factors of adherence to hypertension medication based on health belief model (HBM).
  
  
  METHODS
  A cross-sectional study was conducted in a rural area of the Ardabil city in 2013. This study was carried out using a pre-structured and validated questionnaire. The questionnaire included information on demographic characteristics, lifestyle habits, HBM constructs and adherence to hypertension medication (Morisky 4-Item Self-Report Measure of Medication-taking Behavior [Morisky Medication Adherence Scale]). Data were analyzed with the use of SPSS version 18. P < 0.05 was considered as statistically significant.
  
  
  RESULTS
  A total of 671 hypertensive patients participated in the study (169 were males and 502 were females). The prevalence of adherence was 24% (161/671)% in the study population. Respondents with regular physical activity and nonsmokers were more adherent to hypertension medication when compared to respondents with sedentary lifestyle and smoking (P < 0.01). Based on HBM constructs, the respondents who perceived high susceptibility, severity, benefit had better adherence compared to moderate and low susceptibility, severity, and benefit.
  
  
  CONCLUSIONS
  The prevalence of adherence to hypertension management was low in study population, this due to inadequate perceived susceptibility, perceived, severity, perceived benefit and poor lifestyle factors. Improving adherence in hypertension patients need to recognize the value and importance of patient perceptions medications.
authors.affiliation: Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Kamran
authors.affiliation: Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Sadeghieh Ahari
authors.affiliation: Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Biria
authors.affiliation: Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Malepour
authors.affiliation: Department of Community Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: H
authors.initials: H
authors.lastname: Heydari
keywords: Adherence; Health belief model; Hypertension; Medication; Rural; Self-efficacy