Predictors of Medication Adherence Among Taiwanese Community-Based Adults with Hypertension: The Application of Temporal Self-Regulation Theory

Medication non-adherence remains a persistent public health concern among individuals living with hypertension, where a gap between intention and actual behavior continues to undermine effective blood pressure control. Guided by temporal self-regulation theory (TST), this study examined the roles of intention, behavioral prepotency, and self-regulatory capacity in shaping medication adherence. A cross-sectional telephone survey was conducted in 2024 among a nationally representative sample of 1068 adults with hypertension in Taiwan. Data were collected on Adherence to Refills and Medications Scale (ARMS) adherence score, behavioral constructs, and sociodemographic and clinical characteristics using validated instruments, including the Adherence to Refills and Medications Scale, Behavioral Prepotency Questionnaire, and Brief Self-Control Scale. Multiple linear regression analyses were used to identify predictors and test the moderation effects. Participants had a mean age of 69.4 years, with 54.3% being male. Overall, the ARMS adherence score was moderate (mean = 15.89, SD = 3.53). TST-related constructs explained 36% of the variance in the ARMS score. Beyond behavioral intention, both habit strength and self-regulatory capacity emerged as significant predictors of medication adherence. However, neither construct significantly moderated the intention–adherence relationship. Additionally, older individuals and those with lower educational attainment demonstrated lower ARMS scores, indicating better adherence. These findings highlight the importance of habit formation and self-regulatory processes in promoting sustained medication adherence. These behavior-focused strategies may also inform management of other chronic conditions.