Patient-Related Factors that affect Adherence to anti-hypertensive therapy at Komfo Anokye Teaching Hospital

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Hypertension is still ranked as one of the top chronic medical conditions that affect individuals of all ages worldwide. Patients encounter difficulties during their therapy which leads to uncontrolled blood pressure .The complications that arise mainly due to uncontrolled blood pressure can be greatly reduced with a combination of on-schedule medication taking and the practice of positive lifestyle measures. This can be achieved when patients have positively formed conceptions about their medical condition and medications which invariably impacts on their medication-taking behaviour. The objective was to measure the level of adherence and determine patient-related factors that affect adherence to antihypertensive therapy. An institution-based cross-sectional study was conducted on 326 hypertensive patients who attended the Komfo Anokye Teaching Hospital‟s hypertensive clinic from 1st May, 2014 to 31st July, 2014. A well-structured questionnaire that incorporated the MMAS-8 was administered to participants to evaluate patients‟ level of adherence and also determine if the assessed variables had any influence on patients‟ medication-taking behaviour. Data were entered and analysed using SPSS version 16. One hundred and thirty-three (41%) of the patients were males and 193(59%) were females. Two hundred and twelve (212, 65%) of participants were in the age range 55-79 years with a mean age of 60.59 years (SD=12.03).Two hundred and three (62%) had gone through basic education. Two hundred and five (205, 62.9 %) of the study participants were found to be highly adherent to their medication therapy, with 82 (25.2%) and 39 (11.9%) of the participants being categorised into the medium and low adherence groups respectively. Patients reported forgetfulness, a sense of well-being and side effects of their medications as major reasons for not being able to take their medications as prescribed. Patients were knowledgeable about the dose, dosing frequency and purpose but less knowledgeable about the names and side effects of their medication therapy. v Patients were aware of lifestyle measures adjunctive to medication therapy. The knowledge score on medication therapy was poor and the score on awareness of lifestyle measures was average. No association was found between patients‟ gender (P-value=0.714), age, awareness of hypertensive state (p-value=0.149), awareness of lifestyle measures (0.149), number of years diagnosed hypertensive (P-value=0.175) and patients‟ adherence level. There was an association between patients‟ knowledge about their diet (P-value-0.05), awareness of systolic blood pressure (P-value=0.01) and patients‟ adherence level. More than 50% of the study population highly adhered to their medication therapy and patients‟ adherence level was determined to be influenced by the type of diet likely to affect blood pressure negatively as well as knowledge of the doses and side effects of their antihypertensive medicines.
A thesis submitted to the Department of clinical and social pharmacy, Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the award of master of science in clinical pharmacy.
Hypertension, Medication therapy