<![CDATA[Background: Hypertension remains a major public health problem in Indonesia, with a steadily increasing prevalence and a significant contribution to cardiovascular morbidity and mortality. One of the main challenges in its management is low patient adherence to long-term treatment. This study aims to develop an integrative strategic model to improve adherence to hypertension treatment by combining the perspectives of social determinants of health and health philosophy, which are still rarely integrated in public health studies.Method: This study employed a mixed-methods explanatory sequential design. Quantitative data were collected from 250 hypertensive patients using structured questionnaires and analyzed using multiple linear regression to identify determinants of medication adherence. Subsequently, 20 purposively selected participants were interviewed in-depth, and qualitative data were analyzed using thematic analysis. Significant quantitative determinants were integrated into an adherence model, and its performanceResult: The results showed that treatment adherence was significantly influenced by health literacy (β = 0.41; p < 0.001), family support (β = 0.32; p < 0.01), quality of healthcare services (β = 0.29; p < 0.05), and patient autonomy awareness (β = 0.27; p < 0.05). The developed integrative model demonstrated higher predictive power (R= 0.62) compared to conventional sociodemographic-based models (R² = 0.38). Qualitative findings further confirmed that reflective awareness and individual moral responsibility play important roles in shaping long-term adherence. This integrative approach has the potential to improve long-term medication adherence among patients with hypertension through the integration of health literacy, family support, healthcare service quality, and patient autonomy.]]>
