Antihypertensive medication non-adherence and its associated factors among adult patients with uncontrolled hypertension in a primary care setting

Abstract

Introduction: Medication nonadherence is a significant challenge in the management of patients with hypertension. This study aimed to assess antihypertensive medication nonadherence and its associated factors in a cohort of patients with uncontrolled hypertension. Material and Methods: A cross-sectional study was conducted among 225 adult patients with uncontrolled hypertension systematically selected from attendees of the general outpatient clinic of an academic tertiary hospital in Kano, Nigeria. A structured questionnaire was used to collect data on their sociodemographic, clinical, and follow-up appointment characteristics. An 8-item medication adherence scale was used to assess medication adherence. Results: There were 155 (68.9%) females. The participants' median age (interquartile range [IQR]) was 55 (45–63) years. Their median adherence score (IQR) was 4 (1–6) of 8, while 87.1% were non-adherent to antihypertensive medication. The duration of treatment (p = 0.009), current blood pressure (p = 0.006), and adherence to follow-up clinic appointments (p = 0.0004) were significantly associated with their median medication nonadherence scores. Conclusion: The prevalence of medication non-adherence in this population is high; however, patients who have been treated for more than 5 years, those with high blood pressure readings (Stage 2 hypertension), and those who were adherent to follow-up appointments had worse medication adherence scores than the other counterparts. These findings justify the need to extensively explore (especially those with long duration of treatment and Stage 2 blood pressure readings) and address the reasons for non-adherence to antihypertensive medication (which should include the identified associated factors), given that medication adherence is crucial in controlling hypertension and its consequences.

Keywords

• antihypertensive
• control
• hypertension
• medication non-adherence
• primary care