Factors Associated with Medication Nonadherence among Hypertensives in Ghana and Nigeria.
Background. Blood pressure (BP) control is poor among hypertensives in many parts of sub-Saharan Africa. A potentially modifiable factor for control of BP is medication nonadherence (MNA); our study therefore aimed to determine factors associated with MNA among hypertensives in Ghana and Nigeria. Methodology. We conducted a multicenter cross-sectional study. Patients were recruited from Korle-Bu Hospital (n = 120), Ghana; and University of Port Harcourt Teaching Hospital, (n = 73) Apapa General Hospital Lagos (n = 79) and University College Hospital Ibadan (n = 85), Nigeria. Results. 357 hypertensive patients (42.6% males) participated. MNA was found in 66.7%. Adherence showed correlation with depression (r = -0.208, P < 0.001), concern about medications (r = -0.0347, P = 0.002), and knowledge of hypertension (r = 0.14, P = 0.006). MNA was associated with formal education (P = 0.001) and use of herbal preparation (P = 0.014). MNA was found in 61.7% of uninsured participants versus 73.1% of insured participants (P = 0.032). Poor BP control was observed in 69.7% and there was significant association between MNA and poor BP control (P = 0.006). Conclusion. MNA is high among hypertensives in Ghana and Nigeria and is associated with depression, concern about hypertensive medications, formal education, and use of herbal preparations. The negative association between health insurance and MNA suggests interplay of other factors and needs further investigation.
School of Medicine and Dentistry, University of Ghana, P.O. Box 4236, Accra, Ghana ; Department of Medicine, Korle Bu Teaching Hospital, P.O. Box 77, Accra, Ghana.
Vincent
V
Boima
Department of Paediatrics, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan PMB 5017, Oyo State, Nigeria ; Department of Paediatrics, University College Hospital, Ibadan PMB 5116, Oyo State, Nigeria.
Adebowale Dele
AD
Ademola
Department of Medicine, General Hospital, Randle Avenue, Apapa PMB 1014, Lagos, Nigeria.
Aina Olufemi
AO
Odusola
Department of Medicine, Korle Bu Teaching Hospital, P.O. Box 77, Accra, Ghana.
Francis
F
Agyekum
Cardiology Division, Department of Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt PMB 6173, Rivers State, Nigeria.
Chibuike Eze
CE
Nwafor
Department of Population Health, NYU School of Medicine, 227 E. 30th Street, 6th Floor, New York, NY 10016, USA.
Helen
H
Cole
Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan PMB 5017, Oyo State, Nigeria ; Department of Medicine, University College Hospital, Ibadan PMB 5116, Oyo State, Nigeria.
Babatunde L
BL
Salako
Department of Population Health, NYU School of Medicine, 227 E. 30th Street, 6th Floor, New York, NY 10016, USA ; Global Institute of Public Health, New York University, New York, NY 10003, USA.
Gbenga
G
Ogedegbe
Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153, USA.
Bamidele O
BO
Tayo