Effectiveness of VoxQR (Voice QR Code) In Enhancing Knowledge Medication Adherence for Geriatric Hypertensive Patients in Koronadal City
Authors
St. Alexius College Department of Pharmacy City of Koronadal, South Cotabato (Philippines)
St. Alexius College Department of Pharmacy City of Koronadal, South Cotabato (Philippines)
St. Alexius College Department of Pharmacy City of Koronadal, South Cotabato (Philippines)
St. Alexius College Department of Pharmacy City of Koronadal, South Cotabato (Philippines)
Article Information
DOI: 10.51244/IJRSI.2025.120800369
Subject Category: Health Science
Volume/Issue: 12/9 | Page No: 4090-4127
Publication Timeline
Submitted: 2025-09-29
Accepted: 2025-10-05
Published: 2025-10-15
Abstract
This study examined the effectiveness of VoxQR (Voice-powered QR codes) in enhancing knowledge and medication adherence among geriatric hypertensive patients in Koronadal City, where nonadherence to antihypertensive medication is a common issue due to cognitive decline and difficulty understanding treatment regimens. A quasi-experimental design was employed, and patients aged 60 and above were selected using purposive sampling. Data were gathered using a validated questionnaire that measured adherence and knowledge before and after the intervention. Results showed notable improvements, including a shift in medication adherence from moderate-low to moderate high levels, increased understanding of medication purpose, dosage, and timing. These findings indicate that VoxQR significantly enhanced medication adherence and knowledge, suggesting that voice-based QR technology is a practical and accessible tool for supporting chronic disease management in older adults.
Keywords
VoxQR, medication adherence, knowledge, geriatric hypertension, quasi experimental
Downloads
References
1. Abalos, J. B., Saito, Y., Ramos Jr, M. A., & Cruz, G. T. (2024). Prevalence, awareness, treatment, and control of hypertension among older adults in the Philippines. The Journals of Gerontology: Series A, 79(2), glad155. https://doi.org/10.1093/gerona/glad155. [Google Scholar] [Crossref]
2. Abunales, J. L., Ordoñez, J. R. V., Salandanan, S. B. B., & Ayran, C. M. G. (2024). Evaluation of medication errors among inpatients in a tertiary government hospital’s pulmonary medicine service: A cross-sectional retrospective study. Acta MedicaPhilippina.https://search.bvsalud.org/gim/?lang= en&q=mh%3A%22Antihypertensive+Agents%22. [Google Scholar] [Crossref]
3. Adinkrah, E., Bazargan, M., Wisseh, C., & Assari, S. (2020). Adherence to hypertension medications and lifestyle recommendations among underserved African American middle-aged and older adults. International Journal of Environmental Research and Public Health, 17(18), 6538. https://doi.org/10.3390/ijerph17186538. [Google Scholar] [Crossref]
4. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall. [Google Scholar] [Crossref]
5. Bingham, J. M., Black, M., Anderson, E. J., Li, Y., Toselli, N., Fox, S., ... & SilvaAlmodóvar, A. (2021). Impact of telehealth interventions on medication adherence for patients with type 2 diabetes, hypertension, and/or dyslipidemia: A systematic review. Annals of Pharmacotherapy, 55(5), 637-649. https://doi.org/10.1177/1060028021993123. [Google Scholar] [Crossref]
6. Capranzano, P., Francaviglia, B., Sardone, A., Agnello, F., Valenti, N., Frazzetto, M., & Tamburino, C. (2021). Suitability for elderly with heart disease of a QR code-based feedback of drug intake: Overcoming limitations of current medication adherence telemonitoring systems. International Journal of Cardiology, 327, 209-216. https://doi.org/10.1016/j.ijcard.2020.11.057. [Google Scholar] [Crossref]
7. Choudhry, N. K., Kronish, I. M., Vongpatanasin, W., Ferdinand, K. C., Pavlik, V. N., Egan, B. M., ... & American Heart Association Council on Hypertension; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology. (2022). [Google Scholar] [Crossref]
8. Medication adherence and blood pressure control: A scientific statement from the American Heart Association. Hypertension, 79(1), e1-e14. https://doi.org/10.1161/HYP.0000000000000196. [Google Scholar] [Crossref]
9. DeFulio, A., & Silverman, K. (2012). The use of incentives to reinforce medication adherence. Preventive Medicine, 55, S86-S94. https://doi.org/10.1016/j.ypmed.2012.07.004. [Google Scholar] [Crossref]
10. Devi, R. L., Sangeetha, K., Ragav, A., Ashwin, R., & Ponshanmugakumar, A. (2023, December). QR Code-Enhanced Drug Identification and Access (pp. 1-6). IEEE. https://doi.org/10.1109/ICCEBS56123.2023.10123456. [Google Scholar] [Crossref]
11. Faisal, S., Samoth, D., Aslam, Y., Patel, H., Park, S., Baby, B., & Patel, T. (2023). Key features of smart medication adherence products: Updated scoping review. JMIR Aging, 6, e50990. https://doi.org/10.2196/50990. [Google Scholar] [Crossref]
12. Gavrilova, A., Bandere, D., Rutkovska, I., Šmits, D., Mauriņa, B., Poplavska, E., & Urtāne, I. (2019). Knowledge about disease, medication therapy, and related medication adherence levels among patients with hypertension. Medicina, 55(11), 715. https://doi.org/10.3390/medicina55110715. [Google Scholar] [Crossref]
13. Giron, M. S. T., & Cortes-Maramba, N. P. (2020). Appropriateness of medication prescribing in hospitalized older adults in a tertiary teaching hospital in the Philippines: A cross-sectional study. Drugs-Real World Outcomes, 7, 213-219. https://doi.org/10.1007/s40801-020-00216-0. [Google Scholar] [Crossref]
14. Gutierrez, M. M., & Sakulbumrungsil, R. (2021). Factors associated with medication adherence of hypertensive patients in the Philippines: A systematic review. Clinical Hypertension, 27, 1-15. https://doi.org/10.1186/s40885-021-00243-3. [Google Scholar] [Crossref]
15. Hu, J., Ren, J., Zheng, J., Li, Z., & Xiao, X. (2020). A quasi-experimental study examining QR code-based video education program on anxiety, adherence, and satisfaction in coronary angiography patients. Contemporary Nurse, 56(5-6), 428-440. https://doi.org/10.1080/10376178.2020.1834910. [Google Scholar] [Crossref]
16. Hung, S. H. (2024, July). Enhancing medication adherence for schizophrenia patients in Taiwan through ICT interventions. In 2024 International Conference on Consumer Electronics-Taiwan (ICCE-Taiwan) (pp. 433-434). IEEE. https://doi.org/10.1109/ICCE-Taiwan.2024.00095. [Google Scholar] [Crossref]
17. Jachimowicz, J. M., Gladstone, J. J., Berry, D. A. N., Kirkdale, C. L., Thornley, T., & Galinsky, A. D. (2021). Making medications stick: Improving medication adherence by highlighting the personal health costs of non-compliance. Behavioural Public Policy, 5(3), 396–416. https://doi.org/10.1017/bpp.2019.1 [Google Scholar] [Crossref]
18. Joshitha, K. L., Aravind, E., Akash, S., Suveka, S., Vardhan, J. H., & Siddeshwar, S. A. (2024, April). Design and development of AI-based QR-enabled pharmaceutical dispenser. In Proceedings of the International Conference on Communication, Computing and Internet of Things (IC3IoT) (pp. 1–6). IEEE. [Google Scholar] [Crossref]
19. Jazul, J. P., Arciga, T. M. G., Ante, M. A. C., Berlin, D. G. B., Ravana, L. F. L., Reyes, S. A., & Singh, J. (2021). Assessment of patient understanding of their conventional cardiac medicines and herbal prepared/derived products: Preliminary survey and interviews with selected community-dwelling elderly patients in the Philippines. Journal of Basic and Clinical Physiology and Pharmacology, 32(4), 403– 413. https://doi.org/10.1515/jbcpp-2020-0485. [Google Scholar] [Crossref]
20. Kilic, H. F., Dag, S., & MSc, S. (2020). The relationship between health literacy and medication adherence in a hypertensive patient population. International Journal of Caring Sciences, 13(1), 101–107. [Google Scholar] [Crossref]
21. Liu, F., Song, T., Yu, P., Deng, N., Guan, Y., Yang, Y., & Ma, Y. (2023). Efficacy of an mHealth app to support patients’ self-management of hypertension: Randomized controlled trial. Journal of Medical Internet Research, 25, e43809. https://doi.org/10.2196/43809. [Google Scholar] [Crossref]
22. Lohrasbi, F., Ilali, E. S., Mousavinasab, S. N., & Yaghoubi, T. (2021). Factors associated with health literacy and medication adherence in elderly patients with chronic kidney diseases. Journal of Nursing and Midwifery Sciences, 8(2), 106–113. https://doi.org/10.4103/jnms.jnms_55_20. [Google Scholar] [Crossref]
23. Marengo, L. L., & Barberato-Filho, S. (2023). Involvement of human volunteers in the development and evaluation of wearable devices designed to improve medication adherence: A scoping review. Sensors, 23(7), 3597. https://doi.org/10.3390/s23073597. [Google Scholar] [Crossref]
24. Marseille, B. R., Commodore-Mensah, Y., Davidson, P. M., Baker, D., D'Aoust, R., & Baptiste, D. L. (2021). Improving hypertension knowledge, medication adherence, and blood pressure control: A feasibility study. Journal of Clinical Nursing, 30(19–20), 2960–2967. https://doi.org/10.1111/jocn.15768. [Google Scholar] [Crossref]
25. McGillicuddy, J. W., Chandler, J. L., Sox, L. R., & Taber, D. J. (2020). Exploratory analysis of the impact of an mHealth medication adherence intervention on tacrolimus trough concentration variability: Post hoc results of a randomized controlled trial. Annals of Pharmacotherapy, 54(12), 1185–1193. https://doi.org/10.1177/1060028020931806. [Google Scholar] [Crossref]
26. Oori, M. J., Mohammadi, F., Norouzi, K., Fallahi-Khoshknab, M., & Ebadi, A. (2019). Conceptual model of medication adherence in older adults with high blood pressure—An integrative review of the literature. Current Hypertension Reviews, 15(2), 85–92. https://doi.org/10.2174/1573402114666181022152313. [Google Scholar] [Crossref]
27. Paczkowska, A., Hoffmann, K., Kus, K., Kopciuch, D., Zaprutko, T., Ratajczak, P., ... & Bryl, W. (2021). Impact of patient knowledge on hypertension treatment adherence and efficacy: A single-centre study in Poland. International Journal of Medical Sciences, 18(3), 852–860. https://doi.org/10.7150/ijms.48139. [Google Scholar] [Crossref]
28. Pan, J., Wu, L., Wang, H., Lei, T., Hu, B., Xue, X., & Li, Q. (2019). Determinants of hypertension treatment adherence among a Chinese population using the therapeutic adherence scale for hypertensive patients. Medicine, 98(27), e16116. https://doi.org/10.1097/MD.0000000000016116. [Google Scholar] [Crossref]
29. Patel, T., Ivo, J., Faisal, S., McDougall, A., Carducci, J., Pritchard, S., & Chang, F. (2020). A prospective study of usability and workload of electronic medication adherence products by older adults, caregivers, and health care providers. Journal of Medical Internet Research, 22(6), e18073. https://doi.org/10.2196/18073. [Google Scholar] [Crossref]
30. Perez, C. D. A. (2022). Integration of geriatric content in entry-level physical therapy education in the Philippines: A pilot study. Philippine Journal of Physical Therapy, 1(2), 24–40. [Google Scholar] [Crossref]
31. Poulter, N. R., Borghi, C., Parati, G., Pathak, A., Toli, D., Williams, B., & Schmieder, R. E. (2020). Medication adherence in hypertension. Journal of Hypertension, 38(4), 579–587. https://doi.org/10.1097/HJH.0000000000002338 [Google Scholar] [Crossref]
32. Rosa, J. G. L. D., Catral, C. D. M., Reyes, N. A., Opiso, D. M. S., Ong, E. P., Ornos, E. D. B., ... & Tantengco, O. A. G. (2024). Current status of hypertension care and management in the Philippines. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 27, 103008. https://doi.org/10.1016/j.dsx.2024.103008. [Google Scholar] [Crossref]
33. Sanati, T., Vaezi, A., & Jambarsang, S. (2020). Medication adherence status and its related factors among older adults in Yazd, Iran. Elderly Health Journal, 6(2), 85–90. [Google Scholar] [Crossref]
34. Saqlain, M., Riaz, A., Malik, M. N., Khan, S., Ahmed, A., Kamran, S., & Ali, H. (2019). Medication adherence and its association with health literacy and performance in activities of daily living among elderly hypertensive patients in Islamabad, Pakistan. Medicina, 55(5), 163. https://doi.org/10.3390/medicina55050163 [Google Scholar] [Crossref]
35. Sartori, A. C., Rodrigues Lucena, T. F., Lopes, C. T., Picinin Bernuci, M., & Yamaguchi, M. U. (2020). Educational intervention using WhatsApp on medication adherence in hypertension and diabetes patients: A randomized clinical trial. Telemedicine and e-Health, 26(12), 1526–1532. https://doi.org/10.1089/tmj.2019.0244 [Google Scholar] [Crossref]
36. Shadish, W. R., Cook, T. D., & Campbell, D. T. (2021). Experimental and quasiexperimental designs for generalized causal inference. Cengage Learning. [Google Scholar] [Crossref]
37. Shareinia, H., Sadeghmoghadam, L., Mokhtarzadeh, M. R., Zahrayi, S. M., Jafari, N., & Noori, R. (2020). Relationship between polypharmacy and medication adherence in the hypertensive elderly patients. Disease and Diagnosis, 9(4), 153–157. [Google Scholar] [Crossref]
38. Siddiqui, M., Judd, E. K., Dudenbostel, T., Gupta, P., Tomaszewski, M., Patel, P., ... & Calhoun, D. A. (2020). Antihypertensive medication adherence and confirmation of true refractory hypertension. Hypertension, 75(2), 510–515. https://doi.org/10.1161/HYPERTENSIONAHA.119.14052 [Google Scholar] [Crossref]
39. Simon, S. T., Kini, V., Levy, A. E., & Ho, P. M. (2021). Medication adherence in cardiovascular medicine. BMJ, 374, n1493. https://doi.org/10.1136/bmj.n1493 [Google Scholar] [Crossref]
40. Sison, J. A., Cawed-Mende, R. M., & Oliva, R. V. (2021). Prevalence, awareness, and treatment profile of adult Filipino hypertensive individuals: Philippine Heart [Google Scholar] [Crossref]
41. Association–Council on Hypertension Report on Survey of Hypertension (PRESYON4). Philippine Journal of Cardiology, 49(2), 53–68. [Google Scholar] [Crossref]
42. Suhat, S., Suwandono, A., Adi, M. S., Nugroho, H., Widjanarko, B., & Wahyuni, C. U. (2022). Relationship of health belief model with medication adherence and risk factor prevention in hypertension patients in Cimahi City, Indonesia. Evidence Based Care, 12(2), 51–56. [Google Scholar] [Crossref]
43. Stern, G. M., Pitlick, J. M., Stacy, Z. A., & Crannage, A. J. (2016). Conception of a personalized medication adherence discharge kit for rivaroxaban. Hospital Pharmacy, 51(1), 60–67. https://doi.org/10.1310/hpj5101-60 [Google Scholar] [Crossref]
44. Zhou, T., Wang, R., Gu, S. J., Xie, L. L., Zhao, Q. H., Xiao, M. Z., & Chen, Y. L. (2022). Effectiveness of mobile medical apps in ensuring medication safety among patients with chronic diseases: Systematic review and meta-analysis. JMIR mHealth and uHealth, 10(11), e39819. https://doi.org/10.2196/39819 [Google Scholar] [Crossref]
45. Turana, Y., Tengkawan, J., Chia, Y. C., Shin, J., Chen, C. H., Park, S., ... & Kario, K. (2021). Mental health problems and hypertension in the elderly: Review from the HOPE Asia Network. The Journal of Clinical Hypertension, 23(3), 504–512. https://doi.org/10.1111/jch.14160 [Google Scholar] [Crossref]
46. Uchmanowicz, B., Jankowska, E. A., Uchmanowicz, I., & Morisky, D. E. (2019). Self-reported medication adherence measured with Morisky Medication Adherence Scales and its determinants in hypertensive patients aged ≥60 years: A systematic review and meta-analysis. Frontiers in Pharmacology, 10, 168. https://doi.org/10.3389/fphar.2019.00168 [Google Scholar] [Crossref]
47. Vidad, D. Y., Ampatin, R. E. V., Baldomero, K., De Leon, G. K., Lopez, M. R., Nicandro, V. A., & Malana, J. (2022). Knowledge, attitude, and perception on antibiotic use and antimicrobial resistance among residents of Metro Manila, Philippines. International Journal of Arts, Sciences and Education, 3(4), 142–189. [Google Scholar] [Crossref]
48. Vreeland, K. C. B., Arteta, L. C. G., Basto, K. M. L., Cabaron, C. K. D., Chicombing, R. J. C., Dagayloan, A. J. B., ... & Andal, M. S. (2022). Public awareness, expectations, and views on community pharmacist’s roles and practices in the Philippines. GSC Biological and Pharmaceutical Sciences, 20(1), 22–31. https://doi.org/10.30574/gscbps.2022.20.1.0220 [Google Scholar] [Crossref]
49. Yazdanpanah, Y., Saleh Moghadam, A. R., Mazlom, S. R., Haji Ali Beigloo, R., & Mohajer, S. (2019). Effect of an educational program based on health belief model on medication adherence in elderly patients with hypertension. Evidence Based Care, 9(1), 52–62. [Google Scholar] [Crossref]
Metrics
Views & Downloads
Similar Articles
- Measuring Waste of Patient Time in Health Care at Non-Digitized Hospital: An Observational Study in Bangabandhu Sheikh Mujib Medical University, Bangladesh
- Reaffirming Clinical Confidence in Atorvastatin Therapy: A Digital Outreach Case Study from Tamil Nadu, India
- Clinical Manifestations and Therapeutic Response in a Patient with Hypothyroidism: A Case Report
- Eranda (Ricinus Communis) In Gridhrasi (Sciatica): Classical Rationale, Pharmacology and Clinical Evidence- A Narrative Literature Review
- Magnetotherapy in Pain Management: Mechanisms, Clinical Applications, and Future Perspectives – A Review