(181) Medication adherence and its association with blood pressure control at a teaching hospital in Ghana

Background: A significant proportion of hypertensive patients do not achieve blood pressure (BP) control. In resource-limited settings such as Ghana, adherence to antihypertensive medicines may be sub-optimal.

Objectives: To determine the rate of antihypertensive medication adherence and the relationship between medication adherence and BP control among hypertensive patients at the Korle Bu Teaching Hospital (KBTH)

Methods: We conducted a cross-sectional study using a validated structured questionnaire. We evaluated medication adherence based on the medication taking behaviour sub-scale of the Hill-Bone compliance to high blood pressure therapy scale. We included adult outpatients attending the Polyclinic/Family Medicine clinic of KBTH for hypertension management. Patients who had difficulty communicating, cognitive disorders, and patients less than 18 years were excluded.
Systematic sampling was used to recruit 371 patients from March to April, 2023. Data on patient socio-demographic and clinical characteristics (BP, diabetes, duration of hypertension) were collected.
Main outcome measures:
Medication adherence: responses were rated on a 4-point likert scale. The percentage adherence score per patient was calculated and classified as high (100%), moderate ≥ 80%, and low if less than 80%.
BP control: BP control was defined as BP < 140/90 mmHg
Data were analysed using SPSS. Inferential statistics was used to test relationship between variables. Multivariate analysis was used to account for confounding. P-value < 0.05 showed statistical significance.

Results: The number of responses completed was 371. Majority of respondents were females (72.8%; n=270). Nearly half (48.5%; n=180) had age 65 years and above. The proportion of patients with high adherence was 39.39% (n=148). The proportion of patients with moderate and low adherence were 44.2% (n=164) and 15.9% (n=59) respectively. The proportion of patients with controlled BP was 46.1% (n=171). Patients with high medication adherence were more likely to have controlled BP than patients without high adherence (COR: 1.98; 95% CI: 1.03-3.80, p< 0.05; AOR: 2.10 (95% CI: 1.05-4.18, p- < 0.05). Sociodemographic factors were not associated with BP control except male sex which was 1.88 times more likely to predict BP control (95% CI: 1.03-3.28, p< 0.05).

Conclusions: Antihypertensive medication adherence was sub-optimal, and BP was control was low at the hospital. Medication adherence was significantly associated with BP control. These findings underscore the need for strategies to improve antihypertensive medication adherence. The attention of healthcare practitioners and policy makers is needed.