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Medication Adherence Survey

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

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1

Do you have a consistent schedule for taking your medication?

Please select the option that best describes your medication schedule.
2

Rate your overall adherence to medication on a scale of 1 to 10

Please rate your adherence to medication, with 1 being very poor adherence and 10 being excellent adherence.
3

What challenges do you face in taking your medication as prescribed?

Please provide details on any difficulties you encounter in following your medication regimen.
4

How often do you experience side effects from your medication?

Please select the option that best describes your experience with medication side effects.
5

Have you ever missed taking your medication due to financial constraints?

Please indicate if financial issues have ever impacted your ability to adhere to your medication.
6

Rate your level of understanding of the importance of medication adherence in managing hypertension

Please rate your understanding on a scale of 1 to 10, with 1 being very low understanding and 10 being very high understanding.
7

How do you remind yourself to take your medication?

Please select the option that best reflects how you remember to take your medication.
8

Do you feel that your healthcare provider adequately explains the importance of medication adherence?

Please indicate your perception of the information provided by your healthcare provider.
9

In the past month, how many times have you forgotten to take your medication?

Please provide an estimate of the frequency with which you have missed taking your medication in the past month.
10

Do you find it challenging to adhere to your medication regimen when your symptoms are not present?

Please indicate if you face difficulties in maintaining medication adherence when you are not experiencing symptoms.