Objective  To examine the prevalence and influencing factors of medication compliance among elderly non-communicable chronic diseases (NCDs) patients in rural Shandong province and to provide a reference for effectively improving medication compliance of the patients.

  Methods  Using stratified multistage random cluster sampling, we conducted a questionnaire survey among 7 088 rural residents aged 60 years and above in three prefectures of Shandong province during August – September, 2017. Then, the residents diagnosed with NCDs (including hypertension, diabetes, cardiovascular diseases, and tumor) were identified and their medication compliance and its influencing factors were analyzed.

  Results  Among 7 070 participants with complete information, 3 456 were NCDs patients; of the patients, 37.6% (1 229) were assessed being compliant to their medication. The results of unconditional multivariate logistic regression analysis revealed that the patients aged ≥ 70 years, not being employed, having a poor self-rated health condition, suffering from two NCDs, and with a moderate or high self-efficacy score were more likely to have medication compliance; whereas, the patients with the education of junior high school and below, without regular daily diet, without hospitalization during past one year, and with a fair or poor mental health situation were less likely to have medication compliance.

  Conclusion  The medication compliance is poor and influenced by multiple factors including age, education, employment, daily diet regularity, self-rated health, disease comorbidity, hospitalization during previous one year, mental health, and self-efficacy among rural elderly residents with non-communicable chronic diseases in Shandong province.