Non-Adherence to Antihypertensive Treatment Regimens Among Hypertensive Clients in Selected Hospitals in Yenagoa Metropolis, Bayelsa State, Nigeria
DOI:
https://doi.org/10.66811/dknjtf70Keywords:
hypertension, medication adherence, non-adherence, antihypertensive, Bayelsa State, NigeriaAbstract
Background: Hypertension is still a huge health challenge in sub-Saharan Africa, and poor medication adherence keeps treatment outcomes disappointing. In Bayelsa State, we really do not know much about how bad this problem is or what is driving it. So, this study focused on figuring out how common non-adherence is among people with hypertension at selected hospitals in Yenagoa, and what is causing it.
Methods: A prospective cross-sectional survey was used. Altogether, we recruited 166 hypertensive outpatients from Federal Medical Centre (FMC) and Diete-Koki Memorial Hospital in Yenagoa between June and August 2019, choosing them through proportionate stratified random sampling. Data came from structured, interviewer-administered questionnaires, vetted by experts, with a reliability score of r = 0.84. Responses were analyzed using basic statistics like frequencies, percentages, means, and standard deviations using a mean cut-off of 2.5.
Results: Most respondents were men (58.4%), aged 60 and above (33.7%), married (58.4%), and had at least a secondary school certificate (47%). Around 65% stuck to their medication well, but a worrying number did not. All 11 items checking adherence behaviour scored above the 2.5 mean cut-off, revealing a real problem with non-adherence. The main reasons were: not being able to afford medications (32%), anxiety over taking drugs for life (30.1%), disbelief that health depends on medications (30.3%), forgetfulness (21.1%), and dealing with multiple prescriptions (19%).
Conclusion: Even though adherence was decent overall, plenty of avoidable barriers still stop people from following their treatment properly. There is an urgent need for focused, nurse-led patient education, better financial support, and simpler treatment plans to close the adherence gap in Yenagoa.
Downloads
References
Adeloye, D., Basquill, C., Aderemi, A. V., Thompson, J. Y., & Obi, F. A. (2021). An estimate of the prevalence of hypertension in Nigeria: A systematic review and meta-analysis. Journal of Hypertension, 39(2), 235–244.
Adebowale, A. S., Adeyemi, O. O., & Fagbamigbe, A. F. (2022). Socioeconomic determinants of hypertension control in Nigeria: Evidence from a nationally representative survey. BMC Public Health, 22(1), 1145.
Adepoju, P., Alawode, O. H., & Ogunyemi, D. (2022). Patient satisfaction and waiting time in Nigerian tertiary hospitals: Implications for chronic disease management. African Journal of Primary Health Care & Family Medicine, 14(1), e1–e8.
Adeyemi, O. O., Ojo, O., & Musa, I. (2023). Application of the Theory of Planned Behaviour to medication adherence in chronic diseases in West Africa: A systematic review. Global Health Action, 16(1), 2189045.
Adeyemi, O. O., & Ogunlana, O. O. (2024). Antihypertensive medication adherence in sub-Saharan Africa: A 2024 meta-analysis of 42 studies. Journal of Clinical Hypertension, 26(3), 312–324.
Bosworth, H. B., Granger, B. B., & Mendys, P. (2021). Interventions to improve medication adherence in hypertension: A review of recent
evidence. Current Hypertension Reports, 23(8), 34.
Briggs, N. D., Iyamu, C. E., & Okorodudu, A. O. (2023). Chronic disease burden and health system readiness in the Niger Delta region. Nigerian Journal of Clinical Practice, 26(4), 455–463.
Cutler, R. L., Fernandez-Llimos, F., Frommer, M., & Benrimoj, S. I. (2022). Economic impact of medication non-adherence by disease groups: A systematic review. BMJ Open, 12(5), e058012.
Eze, J. N., Okeke, T. C., & Nwagbo, C. (2022). Medication access and adherence among hypertensive patients in southeastern Nigeria. Journal of Hypertension and Cardiovascular Research, 10(2), 78–85.
Ezeala-Adikaibe, B. A., Mbadiwe, N., & Okudo, G. (2021). Factors associated with medication adherence among hypertensive patients in a tertiary health centre: A cross-sectional study. Archives of Community Medicine and Public Health, 3(1), 024–031.
Horne, R., Faasse, K., Cooper, V., & Diefenbach, M. A. (2021). The Perceptions and Practicalities Approach (PAPA): A framework for understanding adherence to chronic medications. Health Psychology Review, 15(2), 189–205.
Kardas, P., Lewek, P., & Matyjaszczyk, M. (2022). Determinants of medication adherence in hypertension: A global perspective. Pharmacy Practice, 20(1), 2687.
Musa, I. O., Adeyemi, O. O., & Ojo, O. (2020). Prevalence and predictors of antihypertensive non-adherence in Africa: A systematic review. Journal of Human Hypertension, 34(9), 611–620.
Musa, I. O., Ogunrinde, O. G., & Nwankwo, T. O. (2022). Beliefs about medicines and adherence among hypertensive patients in Nigeria: A qualitative study. BMC Cardiovascular Disorders, 22(1), 102.
Ndwiga, J. N., Mbugua, S. N., & Karuri, J. (2021). Impact of medication non-adherence on cardiovascular outcomes in sub-Saharan Africa. Global Heart, 16(1), 45.
Nguetsa, G., Tchoumi, C. T., & Kuate, D. (2022). Effectiveness of SMS reminders on medication adherence in hypertensive patients in Cameroon: A randomized controlled trial. Digital Health, 8, 1–9.
Nieuwlaat, R., Wilczynski, N., Navarro, T., & Haynes, R. B. (2022). Interventions for enhancing medication adherence: Cochrane systematic review. Cochrane Database of Systematic Reviews, 2022(4), CD000011.
Ochieng, P., Mwangi, J., & Otieno, F. (2021). Psychosocial determinants of chronic disease adherence in Kenya: A Theory of Planned Behaviour analysis. African Health Sciences, 21(3), 1120–1129.
Ogunrinde, O. G., Musa, I. O., & Adeyemi, O. O. (2023). Cultural beliefs and hypertension management in Nigeria: Implications for nurse-led education. Journal of Nursing Care, 12(4), 1–8.
Ojo, O., Adebowale, A. S., & Fagbamigbe, A. F. (2023). Polypharmacy and adherence patterns among older hypertensive patients in Nigeria. Journal of Geriatric Cardiology, 20(5), 345–352.
Onoka, C. A., Hanson, K., & Mills, A. (2023). Out-of-pocket health expenditure and medication access in Nigeria: A longitudinal analysis. Health Policy and Planning, 38(2), 189–198.
Onwujekwe, O., Uguru, N., & Ichoku, H. (2021). Digital health interventions for chronic disease management in Nigeria: Evidence from pilot programs. BMJ Global Health, 6(7), e005612.
Owoaje, E., Rotimi, C., & Osotimehin, B. (2022). Hypertension epidemiology and control in sub-Saharan Africa: Current evidence and future directions. Global Health Epidemiology and Genomics, 7, e15.
Oyeyemi, A. L., Adebayo, P. B., & Oluwole, E. O. (2023). Urban-rural disparities in hypertension prevalence and awareness in Nigeria. Nigerian Medical Journal, 64(2), 112–119.
Tadesse, M. A., Shehab, A., Gebreyohannes, E. A., & Elnour, A. A. (2021). Non-adherence to hypertensive drugs: An updated systematic review and meta-analysis (2010–2020). PLOS ONE, 16(8), e0255891.
Uthman, O. A., Wiysonge, C. S., & Ota, M. O. (2023). Cardiovascular disease burden in Africa: A systematic review of prevalence and risk factors. The Lancet Regional Health - Africa, 15, 100345.
Uthman, O. A., Okoroh, J., & Eke, C. (2024). Health system barriers to chronic disease care in Nigeria: A mixed-methods study. Health Systems & Reform, 10(1), 1–12.
Vrijens, B., De Geest, S., Hughes, D. A., & Burnier, M. (2023). A new taxonomy for describing and defining adherence to medications. British Journal of Clinical Pharmacology, 89(4), 1025–1036.
Whelton, P. K., Carey, R. M., Aronow, W. S., & Wright, J. T. (2022). 2022 ACC/AHA guideline for the management of hypertension in adults. Journal of the American College of Cardiology, 80(12), 1255–1302.
WHO. (2023). Hypertension fact sheet. World Health Organization.
WHO. (2024). Package of essential noncommunicable disease interventions (PEN) for primary health care. World Health Organization.
