Factors Associated with Medication Non-adherence among Older Adults with Hypertension : Based on the 2022 and 2024 Korea National Health and Nutrition Examination Survey

This study aimed to explore the associations between medication non-adherence and sociodemographic characteristics, physical and mental health status, and quality of life among older adults (≥65 years) with hypertension. The findings provide foundational evidence for developing tailored nursing interventions and community-based chronic disease management strategies. Using data from the 9th Korea National Health and Nutrition Examination Survey (KNHANES, 2022 and 2024), a cross-sectional secondary data analysis was conducted on 1,967 hypertensive participants. Independent variables included sociodemographic factors, physical health (subjective health status, activity limitation), mental health (depression, anxiety, stress), and quality of life, which were analyzed using complex-sample logistic regression. The results indicated that education level (OR=2.96, p=.007), residential area (OR=0.37, p=.032), and household income (OR=0.35, p=.009) were significantly associated with medication non-adherence. Specifically, an education level of high school or higher and urban residence increased the likelihood of non-adherence, while rural residence and higher household income decreased it. These findings suggest that highly educated, urban older adults may represent a newly vulnerable group for medication non-adherence. Furthermore, the results indirectly imply that the systematic nature of community-based public health services, established in response to the high proportion of the elderly population in rural areas, may have served as a protective factor. Therefore, hypertension management strategies for older adults should extend beyond individual-level factors to include tailored interventions that reflect the structural context of the community. However, as this study is a cross-sectional secondary data analysis that did not directly measure the utilization of public services and applied stringent adherence criteria, there are limitations in interpreting causality and generalizing the result. Future empirical research incorporating variables related to the use of public health services is warranted.