Antihypertensive medication non-adherence and its determinants among patients on follow up in public hospitals in Northern Ethiopia

Background: Adherence to pharmacological treatment for hypertension is considered a key factor in guaranteeing successful therapy outcomes. Non-adherence to antihypertensive therapy can be determined by demographic, drug related, disease related and setting related factors. The primary aim of this study was to investigate antihypertensive medication non-adherence and its determinants among patients on follow up in Ayder referral hospital and Mekelle general hospital. Methods: A prospective cross-sectional study was conducted in Ayder Referral Hospital (ARH) and Mekelle General Hospital (MGH) from May to June, 2013. A total of 121 patients were interviewed with a structured standard questionnaire and patient medication charts were reviewed. The questionnaire contained of demographic questions, the 8-item Morisky medication adherence scale (MMAS) and questions about characteristics of hypertension and its therapy. The data collected were cleaned, entered and analyzed using Statistical Package for Social Science (SPSS) version 16 for windows with 95% confidence interval and P value < 0.05. Results: Around one fourth (26.4%) of the study participants were found to be non-adherent to their treatment. Family support on adherence (AOR = 0.170, 95%CI = 0.030-0.905), spot blood pressure (AOR = 0.052, 95%CI = 0.003-0.242), place of patient residence (AOR = 0.184, 95%CI =0.024-0.597) and hypertension related complications (AOR = 21.737, 95%CI = 1.568-418.428) were found significantly and strongly associated with treatment non-adherence. Conclusions: A quarter of the participants of this study were completely non-adherent and only around half of them were adherent to their medications. The absence of family support, being at the prehypertension class of blood pressure, living in Mekelle city and presence of hypertensive heart disease were shown to decrease adherence to antihypertensive medications. Therefore, health care professionals should be adequately trained and resourced to offer proper counseling to hypertensive patients on their medication and disease conditions.