<![CDATA[Background: Medication adherence is essential for hypertension control and is shaped by patient-, family-, therapy-, condition-, and health-system-related factors. This study examined factors associated with antihypertensive medication adherence among patients in an urban setting using the WHO Five Dimensions of Adherence framework. Methods: A cross-sectional study was conducted from April to May 2026 in four primary health centers across two subdistricts of Denpasar City, Indonesia. A total of 144 hypertensive patients aged 18-59 years were selected through multistage random sampling. Adherence was measured using the eight-item Morisky Medication Adherence Scale. Data were analyzed using descriptive statistics, chi-square tests, and multiple logistic regression. Results: Ninety-four participants (65.3%) were adherent, whereas 50 (34.7%) were non-adherent. In bivariate analyses, adherence was associated with family support, medication availability, quality of healthcare-provider communication, blood-pressure control status, and attitude toward treatment (p<0.05). In the adjusted model, a positive attitude toward treatment showed the strongest association (AOR=5.682; 95%CI: 2.325-13.883), followed by good provider communication (AOR=3.816; 95%CI: 1.493-9.752), good family support (AOR=3.705; 95%CI: 1.445-9.495), and continuous medication availability (AOR=3.569; 95%CI: 1.462-8.714). The model explained 41.1% of adherence variability and achieved 79.2% classification accuracy. Conclusion: Antihypertensive medication adherence in an urban population is associated with patient, family, and health-system factors. Multicomponent interventions should combine attitude-oriented counseling, patient-centered communication, family engagement, and uninterrupted medication supply.]]>
