Indonesian Journal of Pharmacy

Pharmacological Activities, Isolated Compounds, Toxicity, and Potential for New Drug Discovery from the Genus Leea

Purwaniati Purwaniati — 2024-03-25

The genus Leea is a genus of medicinal plants. Half of this genus species are traditionally used to treat various ailments. This genus also holds promise for molecules that have the potential to be used as drugs or lead compounds in the discovery of a new drug. So far, 66 compounds have been isolated from this genus, 46 known to have pharmacological activity. Antioxidant, antimicrobial, anti-inflammatory and anticancer are the pharmacological activities most frequently found in these compounds. Although the toxicity studies are still limited to chronic toxicity tests showing low toxicity potential. The fact that various pharmacological activities and low potential make toxicity makes this plant worthy of continued study. The potential to possibility drugs from this genus is also huge.

Manipulation Strategy to Increase Expression Level of Soluble Recombinant Protein Penicillin G Acylase (PGA) in Bacterial Host Escherichia coli: A Review Article

Achmad Makin Amin — 2024-03-25

The strategy of producing PGA on a massive scale with high levels of soluble protein can be through recombinant genetic techniques and expressed in a certain host. E. coli is still a popular bacterial host to produce a recombinant protein which has advantages such as fast growth, low production cost, and high expression rate. Apart from its advantages, E. coli as a production host also has disadvantages including the expression of recombinant proteins often failing to form the proper folding conformation which makes the protein biologically inactive. Many strategies can be developed to overcome these problems, such as the selection of the host strain (E. coli HB101 & JM109), fusion protein to enhance the recovery of soluble protein (MBP & NusA), optimization of fermentation (low-temperature incubation), and optimization of the protein isolation process for the recovery of active PGA (Freeze-thawing method).

Indonesian Indonesian Medicine Plants for Mental Health Disorders: Anxiety and Depression

Vivi Septya Wati — 2024-03-25

Mental health disorders are currently widely discussed, especially anxiety and depression. The number of people living with anxiety and depression disorders in 2020 increased significantly due to the COVID-19 pandemic. These mental health disorders are quite serious and need to be addressed. Indonesian people for generations have used medicinal plants in everyday life, one of which is to treat symptoms of mental health disorders such as increasing mood and motivation, calming, overcoming depression, stress, anxiety, and sleep disorders. However, there has been no comprehensive review on the ethnopharmacology of Indonesian medicinal plants that can treat mental health disorders such as depression and anxiety and there is also little scientific evidence to support the efficacy of these plants. This paper reviews Indonesian medicinal plants used to treat mental health disorders and reviews the scientific evidence for these plants. We conduct literature studies of scientific articles, research journals, and books at national and international vessels. The search results identified 67 Indonesian medicinal plants used to treat symptoms of mental health disorders. The Zingiberaceae family is reported as the most medicinal plant that can potentially treat mental health disorders such as depression and anxiety. Several plants have been proven in preclinical research, but many still have not been studied and proven. Therefore, further research on Indonesian medicinal plants that can overcome mental health disorders must be carried out to provide knowledge and develop drugs for mental health disorders.

Nephroprotective Effect of Milkfish, Patin, and Snakehead Fish Oil by Suppressing Inflammation and Oxidative Stress in Diabetic Rats

Heru Sasongko — 2024-03-25

Diabetic nephropathy (DN) has been linked to a number of long-term problems caused by diabetes mellitus. Inflammatory and oxidative stress pathways contribute to DN development and progression. Many studies have shown the preventive advantages of diets rich in substances like anti-inflammatory and antioxidant elements like omega-3 fatty acids (n-3 FA) in preventing DN. Milkfish (Chanos chanos F.), patin (Pangasius micronema Blkr.), and snakehead fish (Chana striata Bloch) are types of fish oils that are known to contain n-3 FA. This study aims to prove the nephroprotective effect of the three types of fish oil in a rat model of diabetes mellitus. Thirty male rats were used in this study. The animals were randomly divided into six groups (n = 5): the non-diabetic group, the diabetes mellitus group, the diabetic with 150 mg/kg metformin orally group, the diabetic with 1000 mg/kg milkfish oil orally group, the diabetic with 1000 mg/kg patin fish oil orally group, and the diabetic with 1000 mg/kg snakehead fish oil orally group. Diabetes models were induced using 65 mg/kg streptozotocin and 230 mg/kg nicotinamide intraperitoneally. The test was carried out for 8 weeks, followed by the observation of the biochemical profiles of blood, urine, oxidative stress, and the immunohistochemistry of the kidneys. A normally and homogeneously distributed test followed by a one-way analysis of variance (ANOVA) and the LSD post hoc test were used to look at the data. At p≤0.05, the data was considered statistically significant. The results showed that serum creatinine levels did not differ significantly after the administration of milkfish, catfish, and snakehead fish oil for 8 weeks (p≥0.05). Different results were shown where the levels of serum BUN, uric acid, urine urea, and microalbumin urine were significantly different after administration of the three types of fish oil (p≤0.05). The same results were shown in oxidative stress (superoxide dismutase, glutathione, and malondialdehyde) and inflammation (interleukin-6 and tumor necrosis factor-α) profiles (p≤0.05). The conclusion is that milkfish, patin, and snakehead fish oils have moderate nephroprotection by suppressing inflammation and oxidative stress.

The Phytochemistry profile of Piper betle extract and its Activity Against Hepatitis C Virus

Tutik Sri Wahyuni — 2024-03-25

Hepatitis C virus (HCV) is an RNA virus that is easy to mutate and high risk of resistance. The vaccine for HCV has not been provided yet, and the current treatment is very expensive. To provide alternative and complementary antiviral from plants, this study evaluated the activities of Piper betle (P. betle) against HCV and its combination with existing antiviral drugs, Ribavirin and Simeprevir. The antiviral inhibition was identified by in vitro culture using Huh7it-1 cells and JFH1a HCV. Moreover, the phytochemistry profile was also determined by Thin Layer Chromatography (TLC) and High-Performance Liquid Chromatography (HPLC). The result showed that the ethanol extract of P. betle was possess strong activity with an IC₅₀ value of 0.08 ± 0.028 µg/mL. The mechanism of action revealed the extract dominantly inhibit in the post-entry steps. Furthermore, the combination of P. betle extract with simeprevir increased its anti-HCV activity, however, no effect was observed in the combination with ribavirin. The Western blotting analysis was shown inhibition of NS3 protein levels in a dose-dependent manner. Phytochemistry evaluation was shown for the extract containing flavonoids, polyphenols, and alkaloids. These results suggested that the ethanolic extract of P. betle could be a good candidate for the development or an alternative to anti-HCV drugs.

Keywords: Hepatitis C Virus, Piper betle, Medicinal plants, Simeprevir, Ribavirin, Medicine.

Nephroprotective Effect of Ethanol Extract Abelmoschus manihot l. Leaves in Gentamicin-Induced Mice

Ni Made Dwi Sandhiutami — 2024-03-25

Nephrotoxicity is the most common side effect of gentamicin, an aminoglycoside antibiotic group. It was mediated by oxidative stress mechanisms. Abelmoschus manihot L. leaves (AML) have antioxidant activity flavonoids. This study aims to determine the nephroprotective effect of AML in gentamicin-induced nephrotoxicity using mice models. It conducted an experimental design study in a pharmacology laboratory using mice models. It was conducted experimentally in 7 groups. There are normal, solvent, negative control, and four test groups (given an ethanolic extract of AML at doses of 50, 100, 200, and 400 mg/kgBW) which were administered orally for 7 days. Gentamicin 112 mg/kgBW was induced intraperitoneally ^onthe 8th day. All mice were anesthetized on the 11^th day to collect blood serum and renal organs for further examination. The data were analyzed using SPSS version 26 for One Way ANOVA test and followed by Duncan's post-hoc analysis test. The difference is considered significant if the p-value <0.05. Gentamicin successfully induced renal damage based on increasing creatinine and blood urea nitrogen (BUN) levels. This was by histopathology analysis which showed renal necrosis in the negative control group. Ethanolic extract of AML prevents nephrotoxicity due to gentamicin in a dose-dependent manner in creatinine level but not in BUN and histopathology. However, taken together all results showed that ethanol extract of AML has a nephroprotective effect in gentamicin-induced nephrotoxicity.

Keywords: Abelmoschus manihot L., gentamicin, nephroprotection, renal histopathology

Development and Characterization of Pectin-Based Colon Targeted Pellets Containing Lactobacillus Plantarum FNCC-0461

Anom Anjasmara I Dewa Gede — 2024-03-25

Lactobacillus plantarum FNCC-0461 is a lactic acid bacteria isolated from "dadih" a traditional Indonesian food that has potential as a probiotic. Probiotics can show health benefits if they can maintain cell viability of at least 7 log CFU in the distal ileum and colon. However, most probiotics are not resistant to the extreme conditions of the gastrointestinal tract. Probiotic encapsulation in the form of pectin-based colon targeted pellets is a promising delivery system to overcome probiotic viability problems due to the gastrointestinal tract extreme conditions and can assist release to specific target site in colon. Pellets was produced by extrusion-spheronization method using microcrystalline cellulose (MCC), lactose and pectin. Optimization of spheronization process was carried out by varying the spheronization speed and time while the optimization of pellets formula was carried out by varying the concentration of total pectin and the type of coating polymer (cellulose acetate phthalate (CAP) or shellac). The morphology, particle size, moisture content, micromeritic properties, process yield and viability of pellets were evaluated. Release of probiotics on coated and uncoated pellets were examined at pH 1.2, 6.8 and 7.4 under simulated colon fluid for 24 hours. The formula containing MCC, lactose and pectin (5:4:1) with spheronization speed at 1500 rpm for 15 minutes showed the best pellets characteristic and cell viability. The pellets obtained were spherical, with particle size distribution of 913.57±8.28 μm, process yield of 88.71±1.04 % and viability of 7.50 x 10⁷ cfu/g. Pellets coated with CAP showed the highest cell release in simulated colon fluid of 1.38 x 10⁷ CFU/g at 24 hours. This research proved that CAP coated pellet formulation has promising potential for colon targeted delivery of L. plantarum as well as to protect the viability of probiotics for colon-targeted delivery.

Phytochemical Profile and Bioactivity of the Methanolic Leaf and Root Extracts of South African Bulbine frutescens

Thabiso Katlego Teffo — 2024-03-25

Bulbine frutescens is an indigenous succulent medicinal plant in South Africa. The plant is commonly used traditionally for the treatment of skin related ailments. B. frutescens has been reported to possess antioxidant, anti-viral and antimicrobial properties. To date, most studies have been conducted on the leaves, while limited reports have been documented on the roots, as well as comparative analyses between both plant parts. The aim of this study was to determine the phytochemical content, antioxidant and antibacterial activities in the leaves and roots of B. frutescens. Methanolic extracts of each plant part were assessed on the phytochemical analysis, antioxidant (DPPH, hydrogen peroxide, metal chelating) and antibacterial activity against S. aureus and E. coli. The results from the phytochemical screening showed that the leaves contained more phytochemical groups than the roots. The roots displayed higher total phenolics (991.7 ± 54.1 mg GAE/g), total flavonoid (285.8 ± 60.6 mg QE/g) and total tannin contents (1698.75 ± 28.15 mg GAE/g) than the leaves. The roots also showed a stronger antioxidant activity in DPPH (3.43 ± 0.16 mg/ml) and metal chelating (0.54 ± 0.01 mg/ml) assays, compared to the leaves, which only showed a higher scavenging power against hydrogen peroxide radicals (1.48 ± 0.02 mg/ml) than the roots. Both plant parts showed intermediate zones of inhibition (10-19 mm) against both bacterial strains, with the exception of the leaves which had a 20.67 ± 0.67 mm inhibition against S. aureus. These results validate the uses of both leaves and roots of B. frutescens in traditional medicine and further suggests for the application of the roots in pharmaceutical and cosmetic industries.Bulbine frutescens is an indigenous succulent medicinal plant in South Africa. The plant is commonly used traditionally for the treatment of skin related ailments. B. frutescens has been reported to possess antioxidant, anti-viral and antimicrobial properties. To date, most studies have been conducted on the leaves, while limited reports have been documented on the roots, as well as comparative analyses between both plant parts. The aim of this study was to determine the phytochemical content, antioxidant and antibacterial activities in the leaves and roots of B. frutescens. Methanolic extracts of each plant part were assessed on the phytochemical analysis, antioxidant (DPPH, hydrogen peroxide, metal chelating) and antibacterial activity against S. aureus and E. coli. The results from the phytochemical screening showed that the leaves contained more phytochemical groups than the roots. The roots displayed higher total phenolics (991.7 ± 54.1 mg GAE/g), total flavonoid (285.8 ± 60.6 mg QE/g) and total tannin contents (1698.75 ± 28.15 mg GAE/g) than the leaves. The roots also showed a stronger antioxidant activity in DPPH (3.43 ± 0.16 mg/ml) and metal chelating (0.54 ± 0.01 mg/ml) assays, compared to the leaves, which only showed a higher scavenging power against hydrogen peroxide radicals (1.48 ± 0.02 mg/ml) than the roots. Both plant parts showed intermediate zones of inhibition (10-19 mm) against both bacterial strains, with the exception of the leaves which had a 20.67 ± 0.67 mm inhibition against S. aureus. These results validate the uses of both leaves and roots of B. frutescens in traditional medicine and further suggests for the application of the roots in pharmaceutical and cosmetic industries.

LC-HRMS Metabolite Profiling of Lunasia amara Stem Bark and In Silico Study in Breast Cancer Receptors

Agus Saputra — 2024-03-25

L. amara is a medicinal plant used as an aphrodisiac. Several studies show it has a compound with biological activities such as inhibition of cell proliferation, one of the mechanisms leading to anticancer activities. This study aimed to profile the metabolites and predict activity against two breast cancer receptors (ERα (3ERT) and HER2 (3PPO)) with an in silico approach. Metabolite profiling of water and 80% ethanol extract was analyzed by UHPLC-Q-Orbitrap-HRMS. Also, we performed a radical scavenging activity by 1,1-diphenyl-2-picrylhydrazyl (DPPH). Putative identification of metabolite in L. amara showed the 46 metabolites (4 unknown) were identified and predominantly as quinoline alkaloids. Some of the compounds from glycosides and phenol groups were also identified. From the antioxidant capacity test results, the 80% ethanol extract had a higher radical scavenging capacity than the aqueous extract. Based on the molecular docking results, the highest affinity for the ERα receptor was found in the tested compound tetrahydropapaveroline and exceeded the native 4-OHT ligand. For the HER2 receptor, graveolinine has the highest affinity but is still below the native lapatinib ligand. Ligand interactions with the amino acids Leu 387 and Glu 419 on the active site of the ERα receptor and Phe1004 on the HER2 receptor are thought to play an important role in increasing the energy affinity. Overall, all compounds showed higher affinity for HER2 receptors than ERα. Alkaloids demonstrated anticancer activity. Further research should be conducted to determine the in vitro activity of these compounds on breast cancer cells.

Hesperidin Enhanced the Antimigratory Activity and Senescence-Mediated G2/M Arrest Effect of PGV-1 Against T47D Luminal Breast Cancer Cells

Fauziah Novita Putri Rifai — 2024-03-25

Luminal breast cancer cells exhibit proliferative and metastatic characteristics. Exploration of the effective treatment with minimum side effects is necessary. This study aimed to confirm the combination treatment of a potent anticancer candidate PGV-1 and hesperidin on luminal breast cancer cells, T47D, covering its cytotoxic and anti-migratory activities. PGV-1 showed much stronger cytotoxicity with an IC₅₀ value of 2 μM than that of hesperidin (200 μM) as evaluated by trypan blue exclusion assay, but the combination of the two compounds exhibited a synergistic effect. Propidium iodide (PI) staining with flow cytometry proved that the combination treatment increased the cell population in the G2/M phase. Additionally, the combination treatment increased senescent cells as shown in senescence associated β-galactosidase (SA-β-gal) assay which might correlate to its antiproliferative properties. In addition, the scratch wound healing assay showed that the combination also inhibited cell migration significantly. Molecular docking of the two compounds demonstrated potential interaction with their protein targets in cell cycle machinery, i.e. KIF1, CDK1, TOP2A, CA12, ESR1, FN1, and TYMS. Altogether, these findings strengthen the evidence of anti-cancer properties enhancement of PGV-1 in luminal breast cancer through combining the compound with hesperidin.

The Efficacy of Mung Bean Drink with Inulin and Iron Tablets in the Erythropoiesis Response of Adolescent Girls with Iron Deficiency Anemia: A Randomized Controlled Trial

Fachriani Putri — 2024-03-25

This study aims to determine the effectiveness of mung bean drink with inulin and iron tablets on the erythropoiesis response as characterized by changes in reticulocyte count of adolescent girls with iron deficiency anemia. This is a non-blinding, randomized controlled trial with pre-test-post-test with control groups research design which was conducted in Sleman Regency, Yogyakarta, Indonesia. Sixty-one adolescent girls with iron deficiency anemia were recruited from junior and senior high schools and then randomized into two groups. The treatment group (n=30) received iron tablets and a mung bean drink with inulin, whereas the control group (n=31) received iron tablets and a palm sugar drink. The intervention was carried out for 12 weeks. Data collection involved interviews, monitoring adherence to drinking, and blood tests. Data were analyzed using Chi-Square Tests, paired T-Tests, and Mann-Whitney Tests. The results showed that there was a significant increase in reticulocyte count after two weeks of intervention in the treatment group (p-value 0.0001) and the control group (p-value 0.001). After four and 12 weeks of intervention, reticulocyte counts of both groups decreased along with increasing hemoglobin levels. In conclusion, the mung bean drink with inulin and iron tablets is effective in the erythropoiesis response.

The Influence of MTHFR C677T Variants on Neuropathy Risk Among T2dm Patients Receiving Monotherapy Metformin

Michael Resta Surya Yanuar — 2024-03-25

Neuropathy is the most common microvascular complication among type 2 diabetes mellitus (T2DM). Metformin consumption increases neuropathy risk. The Methylenetetrahydrofolate reductase (MTHFR) enzyme has confirmed its role in neuropathy. Metformin and MTHFR could decrease folate and induce hyperhomoscysteine. One of the common variants of the MTHFR gene is C677T and its located in the exon area. This study aimed to observe the association between variant C677T in the MTHFR gene and the risk of neuropathy among newly diagnosed T2DM patients with naive metformin. This cross-sectional study recruited 103 patients. The neuropathy risk was examined according to medical judgment through Neuropathy Symptom Score (NSS) and Neuropathy Disability Score (NDS) criteria. Genotyping C677T was performed using PCR-RFLP. This study found only one patient has a homozygote mutant, but more than 50% of patients were detected with allele mutants. There were no statistical differences in patient characteristics between CC and CT genotypes (p>0.05). Association between C677T and neuropathy risk was not significant statistically, either in the genotype model (p=0.97), allele model (p=0.82), and dominant model (p=0.91). There was still no significant association after adjusting for several confounding factors. We conclude that C677T in our population did not influence neuropathy risk. More specific criteria and laboratory parameters indicated neuropathy should be examined in the future study.

Keywords: MTHFR, neuropathy, metformin, and T2DM

Impact of Dapagliflozin as Add-on Therapy on Glycemic Status and Quality of Life in Type 2 Diabetic Patients

Hadeel Delman Najim — 2024-03-25

Evaluate the efficacy of dapagliflozin on glycaemic and non-glycaemic indices and assess quality of life in type 2 diabetes patients (T2DM) with inadequate glycaemic control on three oral antidiabetic agents (OADs). Patients with uncontrolled type 2 diabetes [Haemoglobin A1c 7.0%-12.0%] on sulfonylurea, metformin and gliptin were selected to receive dapagliflozin 5mg/day for 16 weeks (n=40). Fasting and postprandial plasma glucose, glycated haemoglobin A1c, body weight, and waist circumference were measured. Assessment of patients’ quality of life was performed using Quality of Life Scale for Iraqi Diabetic patients (QOLSID) at baseline and after administration of dapagliflozin. Dapagliflozin showed high significant reduction in fasting and postprandial plasma glucose, glycated haemoglobin A1c (HbA1c), body mass index (BMI) and index of central obesity (ICO) (p<0.001). High significant changes in the QOLSID score after treatment (p<0.001). High BMI is negative predictor for patients’ quality of life. Dapagliflozin improved both glycaemic and non-glycaemic parameters in T2DM patients who already on three OADs. This is promising results in short period makes the treatment a suitable alternative to insulin specially in patients not prefer to use injected medication. Dapagliflozin showed an improvement in the patients’ physical and psychological condition and consequently overall QOL.

Empirical Studies Assessing the Perceptions and Knowledge of Medicine in Mongolia: A Nationwide Population-Based Study

Dulmaa Lkhagvasuren — 2024-03-25

The availability and affordability of medicine is an essential issue in any population globally, and drug regulatory agencies need the information to prevent an unforeseen matter and take necessary decisions by relevant agencies so that medicine will be available at an affordable price. Moreover, it is also essential to assess the consumer perception of patterns and knowledge about medicine use, subject to perception bias and belief bias. The current study examines consumers’ perceptions of medicine availability, medicine spending, affordability of medicine, patterns and knowledge of medication use. A nationwide cross-sectional study was performed in Mongolia. The survey consists of nineteen closed-ended questionnaire items. The manuscript has presented according to The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines on the cross-sectional study. A total of seven thousand five hundred and thirty-two (n=7532) had participated in the study. 46.3% of the study population consider the quality during buying of medicine. The average spending of medicine per month in Mongolia is 4.00 USD-17.00 USD/= per month. A large percentage of the population (47.8%) has skipped buying prescription drugs due to affordability issues. 47.4% of the population believe that the price of the drug sold in the market is expensive. A surprisingly 56% of study population indicate that the pharmacy does not have enough type and stock of drug. The study population (40.4%) does not have enough awareness about falsified medicine, and 30.4% cannot buy discounted medicine covered by the health insurance fund. A considerable percentage of the population (74.2%) take medicine according to doctor instructions and is firmly in favour of the government to regulate the drug prices (79.9%). The current study showed consumers’ perception, pattern, knowledge and affordability about medicines. The results indicate a lack of education by the healthcare providers on falsified medicine, the financial burden of medicine on the population, and the unavailability of different medicine stock.

Development of Willingness-to-Pay Questionnaire on Health Insurance Cost-Sharing for Catastrophic Prescription Drugs: A Content Validity and Reliability Assessment

Diesty Anita Nugraheni — 2024-03-25

Prescription drug cost-sharing in Indonesia remains challenging because no valid willingness-to-pay (WTP) questionnaire for this cost-sharing is available. The aim of this study was to conduct item selection and evaluate the content validity of the questionnaire on the WTP for prescription drug cost-sharing under the national health insurance scheme in patients with catastrophic illnesses. The method was a cross-sectional study and used a three-step design, namely literature review, consultation with some health economics experts, and evaluation of content validity. This study involved 9 experts, consisting of academicians and health professionals who worked in a hospital, to perform content validation of a questionnaire on the WTP for prescription drug cost-sharing. This study used CVI (content validity index) and CVR (content validity ratio) for both individual item measurement and the overall scale. This study's results reveal a questionnaire comprising 47 items grouped into five domains: healthcare utilization information, participation in health insurance information, drug information, and cost-sharing scenarios. The questionnaire items were extracted from many sources. The items that could be used for the study should have an I-CVI of 0.79-1.00. There were three items removed because of criticisms from the experts and Item-CVI<0.79 and CVR<0.62. Those with Item-CVI>0.79 were revised. The overall scale of the questionnaire was excellent with an S-CVI/Ave of 0.94. We conclude that the questionnaire on the willingness-to-pay for prescription drug cost-sharing was developed and validated through expert consultation, item selection, and CVI. The questionnaire reviewed in this study had good content validity. As a follow-up, a new 42-item questionnaire was developed.

Predicting the Intention to Adhere to Hypertensive Medication among Seniors: A Cross-Sectional Survey

Niken Nur Widyakusuma — 2024-03-25

Non-adherence to hypertension treatment is a wide problem, especially among senior citizens. Several approaches are needed to improve adherence, including identifying and prioritizing problems related to adherence. A formative study employing Theory of Planned Behavior (TPB) has revealed some salient beliefs underlying the intention to adhere to hypertension medication among seniors. To be the priority in a medication adherence strategy, the correlation of these beliefs on adherence needs to be further investigated. This study aims to determine which beliefs correlate most to the intention to hypertension medication adherence among seniors. A cross-sectional survey was conducted to seniors with hypertension in Yogyakarta and its surroundings. A questionnaire based on TPB was developed and utilized in this study. The questionnaire was distributed conveniently through two senior communities (offline) as well as Google Form link to some WhatsApp group of seniors (online) during September-October 2023. The data were analyzed using multiple linear regressions. Thirty-seven seniors completed the offline questionnaire, and 60 seniors completed the online questionnaire. The age of participants was 64.70 ± 7.123 years. Subjective norms and perceived behavioral control accounted significantly (p<0.001) for 59,3% of the variance in the adherence intention, but not attitude. Perceived behavioral control had the strongest correlation on intention. Participants’ beliefs of knowing how high their blood pressure was had the highest correlation to perceived behavioral control. Understanding which belief correlates most with intention to adherence provides insight to develop strategy to improve adherence among seniors.