Predictors of Non-adherence to Antihypertensive Therapy in a Rural Health Facility in Kenya

Abstract

Background: The effectiveness of antihypertensive medicines depends on whether the patient uses the drugs as instructed by the health care provider. Failure to adhere to therapy may lead to uncontrolled blood pressure and possibly preventable complications. The factors which may impact on adherence to medicines among patients in rural health facilities have not been adequately documented.

Objective: To determine the predictors of non- adherence to antihypertensive therapy in Murang’a South Sub-county Hospital.

Methods: A descriptive cross-sectional study design was used. One hundred and sixty-seven adult hypertensive patients who were on therapy at Murang’a South Sub-county Hospital were included. Participants who satisfied the inclusion criteria were selected using simple random sampling. Data was collected using a researcher administered questionnaire. Analysis was carried out using STATA version 14 statistical software and p</=0.05 was considered statistically significant. Permission to conduct the study was granted by the Kenyatta National Hospital-University of Nairobi Ethical and Research committee and the management of the hospital.

Results: There was female predominance (124, 74.3%).One hundred and twelve (67.5%) participants were adherent to medications. The independent predictors of non-adherence were; lack of finances (p=0.000), inadequate knowledge on treatment (p=0.005), long duration of treatment (p=0.001), forgetfulness (p=0.003), side effects of drugs (p=0.019) and fear of dependence (p=0.008).

Conclusion: Patient factors were major contributors to non- adherence. Clinicians should be encouraged to provide adequate counseling to improve adherence.