Non-Compliance to Antihypertensive Medication among Hypertensive Patients Attending Ghana Ports and Harbours Authority Clinic, Tema

ABSTRACT

Background:  Noncompliance to antihypertensive medication is a big public health problem to the management of high blood pressure and predisposes majority of the hypertension patients to cardiovascular complications. According to World Health Organization (WHO) report, the problem of uncontrolled blood pressure, which is estimated to be 52-74% of patients, is largely because of poor compliance to prescribed antihypertensive medication. The purpose of this study was to determine the prevalence and factors influencing noncompliance to antihypertensive medications among hypertensive patients of Ghana Ports and Harbours Authority Clinic, Tema.

Method:  A cross sectional survey was conducted between May 2019 and June 2019. A sample of 392 patients diagnosed of hypertension and on medication for not less than six months were selected by consecutive sampling. Data was retrieved through face-to-face interview using a structured questionnaire. The Donald Morisky medication adherence scale was adopted to design questions relating to antihypertensive adherence. The association between the exposure variables and noncompliance was analyzed by using multiple logistic regression and tested with Chi Square reporting crude and adjusted odd ratios with their 95% confidence intervals.

Results: Data was collected from 386 patients between the ages 24 to 84 years with an average age of 53.4. The prevalence of noncompliance to antihypertensive medication was 57.2% among hypertensive patients at GPHA clinic (p = 0.57, 95% CI = 0.52 – 0.62). Age (aOR = 0.97; 95% CI = 0.93 – 0.99; p = 0.035), Marital Status, divorced (aOR = 4.98; 95% CI = 1.08 – 22.85; p =0.039) and widowed (aOR= 5.03; 95% CI = 1.17 – 21.59; p = 0.030), Educational level, senior high (aOR = 0.07; 95% CI = 0.01 – 0.50; p = 0.008) and junior high (aOR = 0.12; 95% CI = 0.02 – 0.81; p = 0.029), Attribution of spiritual cause to hypertension (aOR = 8.05; 95% CI = 1.33 – 48.57; p = 0.023), Waiting time for consultation, 1 – 2 hours  (aOR = 3.26; 95% CI = 1.48 – 7.18; p = 0.003) and Waiting time for drug refill, 30 minutes – 1 hour (aOR = 0.47; 95% CI = 0.25 – 0.88; p = 0.018 )‖ were found to be significant predictors of noncompliance.

Conclusion: More than half of the respondents were noncompliance. Education, age and waiting time for drug refill reduce noncompliance whilst marital status and waiting time for consultation, and attribution of spiritual cause to hypertension increases noncompliance to antihypertensive medication. The Ghana Health Service should incorporate education on hypertension and importance of complying with treatment. The Ghana Ports and Harbours Authority Clinic should put in necessary measures to reduce longer waiting time for patients with hypertension seeking health service at the facility.