Abstract
Beyond medical prescription for hypertension treatment, management requires consistent level of adherence, high quality of care and adaptive coping strategies, which are rarely considered. Our study analysed the moderating role of coping strategies in the relationship between perceived quality of care and treatment adherence among hypertensive patients. A hospital-based retrospective observational cohort study was conducted among adult hypertensive patients who attended clinic at a tertiary hospital between August 2023 and July 2024. A total of 621 consenting patients were purposively surveyed using three pre-existing instruments: Adherence to Systemic Hypertension Treatment Scale, the Service Quality Questionnaire, and the Coping Inventory for Stressful Situations-21 (CISS-21). Data were analysed using correlation and bootstrap moderation analyses. The correlation matrix showed weak positive associations between age and adherence (Spearman's rho = 0.098, p = 0.014), comorbidities and adherence (Spearman's rho = 0.068, p = 0.091), as well as BP and comorbidities (Spearman's rho = 0.074, p = 0.065). Males were more likely to exhibit lower adherence to hypertension treatment compared to females. As females' perception of quality care increased, so did their adherence to treatment. Among the three coping strategies, only task-oriented coping significantly moderated the relationship between perceived quality of care and treatment adherence (B = 0.268, 95% CI = 0.17-0.365). While sex differences should be considered in treatment adherence initiatives, task-oriented coping may play a crucial role in improving adherence, particularly among individuals with a positive perception of care quality. Addressing sex-specific barriers and promoting task-oriented coping strategies could enhance treatment adherence.