Changes in Medication Adherence Following Booklet-Based Education Among Patients With Hypertension: A Pre-Experimental Study

Abstract

Hypertension is a non-communicable disease that may lead to serious complications if not properly controlled, and medication adherence is a key factor in blood pressure control among hypertensive patients. Health education using booklet media may be a feasible strategy to improve patients’ understanding of hypertension and, potentially, their medication-taking behavior. This study aimed to examine changes in medication adherence among hypertensive patients following education using booklet media at Belimbing Primary Health Center, Padang. A quantitative pre-experimental one-group pretest-posttest design, without a comparison or control group, was used. The study was conducted from February 5 to February 27, 2026, and involved 40 respondents recruited using an accidental sampling technique from among hypertensive patients visiting the health center. Medication adherence was measured using the Morisky Medication Adherence Scale (MMAS-8) before and two weeks after the educational intervention. Data were analyzed using the Wilcoxon Signed-Rank Test for paired pretest-posttest comparison. The mean adherence score increased from 5.88 (SD = 1.539) before the intervention to 7.40 (SD = 0.871) after the intervention, a mean difference of 1.52, with a statistically significant paired difference (Wilcoxon Signed-Rank Test, p < 0.001). These findings indicate that medication adherence changed favorably following booklet-based education among hypertensive patients in this single-group study. Given the absence of a control group, these results should be interpreted as evidence of feasibility rather than a confirmed causal effect; booklet media, particularly when equipped with digital (QR-code) access, may be considered as a supportive component of hypertension health education, pending confirmation in controlled studies with longer follow-up.