Predictors of medication nonadherence among hypertensive clients in a Ghanaian population: Application of the Hill-Bone and Perceived Barriers to Treatment Compliance Scale.

BACKGROUND AND AIM

Nonadherence to antihypertensive medication impairs optimal blood pressure and is influenced by multiple interrelating factors. Knowing the complexity of medication nonadherence and its associated factors is essential for intervention strategies. This study evaluated the predictors of medication nonadherence among hypertensive clients in a Ghanaian population.

METHODS

This was a hospital-based cross-sectional study conducted at the Hypertensive Clinic of the Kwame Nkrumah University of Science and Technology (KNUST) Hospital, Kumasi, Ghana. A self-designed questionnaire, the Hill-Bone Compliance to High Blood Pressure Therapy and Perceived Barriers to Treatment Compliance Scales, were used for data collection from 246 hypertensives. Data were analyzed using Statistical Package for Social Sciences, version 25.

RESULTS

Medication nonadherence was observed among 8.5% of the study participants. In a multivariate regression model perceived noneffectiveness of medication (odds ratio [OR] = 1.76, 95% confidence interval [CI]: 1.34-2.31,  < 0.001) and barriers to alcohol and smoking cessation (OR = 2.83, 95% CI: 1.31-6.13,  = 0.008) were associated increased odds of antihypertensive medication nonadherence. Also, patients who do not know their total prescription (OR = 8.81, 95% CI: 2.28-34.0,  = 0.002) were more likely to be nonadherent to their antihypertensive medications. Moreover, clients who associate signs/symptoms of palpitations (OR = 5.82, 95% CI: 1.31-25.80,  = 0.021), poor sleep (OR = 3.92, 95% CI: 1.09-14.12,  = 0.036) and decreased sexual drive (OR = 4.74, 95% CI: 0.96-23.28,  = 0.055), were more likely to be nonadherent to antihypertensive medication.

CONCLUSION

In conclusion, we observed a lower nonadherence rate among hypertensive clients in a Ghanaian population with correlates being medication-related factors. Most importantly, perceived noneffectiveness of medication, barriers to smoking and alcohol cessation, palpitations, poor sleep, and decreased sexual drive significantly predicted lower adherence and could serve as indicators for high risk of nonadherence to antihypertensive medications.