Factors Influencing Adherence To Oral Antihypertensive Medication Amongst Patients Attending The Korle-Bu Teaching Hospital

Abstract

Introduction: Medication adherence is an integral component in the management of hypertension. Poor adherence to medications is one of the major public health challenges. Sub optimal adherence to antihypertensive medication is a major risk factor for many cardiovascular diseases. Good medication adherence would ensure adequate blood control and therefore reduce cardiovascular morbidity and mortality. The objective was to measure adherence levels amongst hypertensive patients and to determine factors influencing their adherence to antihypertensive medications. Method: A cross sectional study was conducted at the O.P.D of the Korle Bu Teaching Hospital in Accra amongst 413 hypertensive patients aged 18 years and above. The Morisky Medication Adherence Scale (MMAS-8) was used to determine the levels of adherence. Good adherence was defined as MMAS scores of 6 and more out of a total score of 8. Results: Overall, 197(47.7%) patients had good adherence to antihypertensive medication. After multivariate adjustment marital status was the most significant; compared with the singles the adjusted odds for the divorced was lower, OR 0.19 (95%CI, 0.06 – 0.65). Additionally being a professional, earning a monthly income of ₵601 and above, duration of 5 to 10 years hypertension , presence of side effects, taking more antihypertensive tablets daily, and unacceptable waiting time at the clinic were all associated with poor adherence. Conclusion: There is an overall poor adherence rate of 52.3% among adult hypertensive users at KBTH. This prompts the need for continuous health education especially amongst new hypertensive patients with emphasis on its causes, severity, medications and consequences of non adherence with treatment.