title: Locus of control and anti-hypertensive medication adherence in Ghana.
abstract: BACKGROUND
  Medication non-adherence is a major public health problem in Ghana. Locus of control (LoC) may influence adherence to medication. In this study we examine the association between locus orientation and adherence to hypertensive medication among adult patients. We also take into account the role of medication side effects.
  
  
  METHODS
  We conducted a hospital-based cross-sectional study involving two tertiary hospitals in southern and northern Ghana. Data were collected from 400 hypertensive patients using a structured questionnaire. We gathered information on patient's sociodemographic characteristics, health LoC, side effects of anti-hypertensive medication and adherence to anti-hypertensive medication.
  
  
  RESULTS
  Participants exhibited features of mixed LoC (both internal and external) usually referred to as bi-local expectancy. However, orientation was skewed towards external LoC. Females were marginally more likely than males to have an internal LoC. Education was associated with a greater likelihood of internal LoC. While most patients (93.3%) poorly adhered to antihypertensive medications, logistic regression model revealed that non-adherence was significantly associated with low internal LoC, medication side effects and the combined effect of medication side effects and external LoC.
  
  
  CONCLUSIONS
  Medication non-adherence, experiences of medication side effects and LoC are associated. Multifaceted intervention programmes highlighting personality characteristics like LoC may improve anti-hypertensive medication adherence.
authors.affiliation: Department of Clinical and Social Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Ghana ; Department of Pharmacy Practice and Clinical Pharmacy, University of Ghana School of Pharmacy, College of Health Sciences, Ghana.
authors.forename: Irene Akwo
authors.initials: IA
authors.lastname: Kretchy
authors.affiliation: Department of Clinical and Social Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Ghana.
authors.forename: Frances Thelma
authors.initials: FT
authors.lastname: Owusu-Daaku
authors.affiliation: Department of Psychology, University of Ghana, Legon, Ghana.
authors.forename: Samuel
authors.initials: S
authors.lastname: Danquah
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D005869:Ghana; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007389:Internal-External Control; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents
keywords: Ghana; Locus of control; bi-local expectancy; collectivism; culture; hypertension; individualism; medication non-adherence; medication side effects; personality