Predictors of adherence to hypertension treatment among adult patients attending Medical Out-Patient Clinics of a secondary health care facility in Southwestern Nigeria

Abstract

Background: Hypertension has been found to be one of the preventable risk factors for renal, cardiac and blood vessel diseases and hence there is a need to achieve control. Despite new guideline s and development of new drug s in treatment of hypertension, a significant number of patients remained uncontrolled. Adherence has been found to affect blood pressure control according to literature. Demographic characteristics, severity of disease, number of drugs and doses prescribed and side effects of some drugs have been found to affect adherence. Achieving good control of hypertension will reduce rate of emergency admissions, health care expenses, strain in family income, days off work, depression and invariably improve quality of life in patients with hypertension. Aims: To evaluate the predictors of adherence to treatment of hypertension among patients attending Medical Outpatients clinic at a secondary health care facility in southwest Nigeria. Methods: The study was a cross sectional study of 386 randomly selected adults with uncontrolled hypertension aged between 18years and 70years on treatment and follow up conducted at the Medical Outpatient clinic of the State Hospital Oyo. Chisquare test was used for bivariate analyses to test the significance of the association between categorical variables and adherence to medications. Logistic regression analysis was performed for the various factors to show the predictors of adherence to treatment of hypertension. Data was analyzed using Statistical Package for Social Sciences (SPSS) soft-ware version 15 and a p-value of ≤ 0.05 was considered to indicate statistical significance. Results: Hypertensive patients with monthly income of ≥ N13, 600 were about three times more likely to have good treatment adherence compared to those who were earning < N13,600 monthly. (OR= 2.815; 95% CI= 1.103 - 7.186). Also, hypertensive patients on single medication were about six times more likely to have good adherence to medications compared to those on three drugs (OR= 6.184; 95%CI= 1.141 -33.533). Conclusion: The predictors of good adherence to anti-hypertensive therapy included monthly income and the number of drugs used by the patients. The prescriptions of efficacious, cost-effective medications, single dose daily therapy with minimal side effects will improve patient adherence to therapy.