PATTERN AND EXPLANATORY FACTORS FOR MEDICATION ADHERENCE AMONG PATIENTS WITH HYPERTENSION, DIABETES MELLITUS AND THEIR COMORBIDITY IN A NORTH CENTRAL STATE OF NIGERIA

Abstract

ABSTRACT

Introduction: Hypertension and diabetes are the two most common non-communicable diseases seen in outpatient clinics in Sub-Saharan Africa. Promoting medication adherence is a major clinical hurdle to be crossed in reducing the premature morbidity and mortality associated with these diseases. This study explored factors that predict medication adherence among hypertensive and diabetic patients in Ilorin, Nigeria.

Methods: This cross-sectional study was carried out among hypertensive and diabetic patients in outpatient clinics of a teaching hospital in Ilorin, Nigeria. Data was collected from 1,203 patients using a validated Morisky 8-item medication adherence questionnaire. Multivariate ordinal logistic regression was used to model the medication adherence explanatory factors with SPSS version 22.

Results: Less than half (43.3%) of the patients were highly adherent to their medication. The relative proportion for high adherence was 42.7%, 35.6% and 49.2% for hypertension, diabetes and both diseases respectively. The odds of medication adherence improving from either low to medium level or from medium to high level was explained by; age, symptoms count, absence of disease complication and absence of drug side effect among the patients. Blood pressure, gender and disease duration did not explain medication adherence among hypertensive and diabetic patients.

Conclusion: It is concluded that the discomfort experienced due to the disease condition and the medication regimen are important explanatory factors for patient’s medication adherence in the study setting. This study recommends strategies to reduce multiple drug combinations and promote medication adherence counselling and education among patients.

Keywords: Hypertension, Diabetes, Medication adherence, Explanatory factors