Predictors of Noncompliance to Antihypertensive Therapy among Hypertensive Patients Ghana: Application of Health Belief Model

Abstract

This study determined noncompliance to antihypertensive therapy (AHT) and its associated factors in a Ghanaian population by using the health belief model (HBM). This descriptive cross-sectional study conducted at Kintampo Municipality in Ghana recruited a total of 678 hypertensive patients. The questionnaire constituted information regarding sociodemographics, a five-Likert type HBM questionnaire, and lifestyle-related factors. The rate of noncompliance to AHT in this study was 58.6%. The mean age (SD) of the participants was 43.5 (±5.2) years and median duration of hypertension was 2 years. Overall, the five HBM constructs explained 31.7% of the variance in noncompliance to AHT with a prediction accuracy of 77.5%, after adjusting for age, gender, and duration of condition. Higher levels of perceived benefits of using medicine [aOR=0.55(0.36-0.82),p=0.0001] and cue to actions [aOR=0.59(0.38-0.90),p=0.0008] were significantly associated with reduced noncompliance while perceived susceptibility [aOR=3.05(2.20-6.25), p<0.0001], perceived barrier [aOR=2.14(1.56-2.92), p<0.0001], and perceived severity [aOR=4.20(2.93-6.00),p<0.0001] were significantly associated with increased noncompliance to AHT. Participant who had completed tertiary education [aOR=0.27(0.17-0.43), p<0.0001] and had regular source of income [aOR=0.52(0.38-0.71), p<0.0001] were less likely to be noncompliant. However, being a government employee [aOR=4.16(1.93-8.96), p=0.0002)] was significantly associated increased noncompliance to AHT. Noncompliance to AHT was considerably high and HBM is generally reliable in assessing treatment noncompliance in the Ghanaian hypertensive patients. The significant predictors of noncompliance to AHT were higher level of perceived barriers, susceptibility, and severity. Intervention programmes could be guided by the association of risk factors, HBM constructs with noncompliance to AHT in clinical practice.

The Role of Lifestyle Factors in Controlling Blood Pressure among Hypertensive Patients in Two Health Facilities in Urban Ghana: A Cross-Sectional Study

“…Within this population of urban adults, alcohol consumption also did not have a significant effect on blood pressure control. This finding is at variance with other studies of alcohol use and hypertension in Ghana [ 35 ]. It is plausible that, in this population, alcohol consumption reported was relatively lower and thus not of significant influence.…”

“…The fact that a larger proportion of patients on antihypertensive medication, however, are unable to control their blood pressure is a worrying issue. Sarfo et al [ 12 ] and Obirikorang et al [ 35 ] similarly reported that patients diagnosed over a longer period more often have poor blood pressure control. This highlights a potential predisposition of prolonged duration of the disease to a lowered motivation to control the disease and low perceived severity of the condition in such patients [ 35 ].…”

“…Sarfo et al [ 12 ] and Obirikorang et al [ 35 ] similarly reported that patients diagnosed over a longer period more often have poor blood pressure control. This highlights a potential predisposition of prolonged duration of the disease to a lowered motivation to control the disease and low perceived severity of the condition in such patients [ 35 ]. This poor observance has been reported as an important contributor to inconsistencies in blood pressure control across different settings [ 36 ].…”

Demographic and Lifestyle Predictors of Prehypertension: A Cross-Sectional Study among Apparently Healthy Adults in Kumasi, Ghana

“…In Ghana, hypertension is the second leading cause of outpatient morbidity among adults [6], with prevalence ranging from 19 to 48% [7, 8]. The high morbidity has been associated with inadequate rates of detection, treatment, and control [6] as well as noncompliance to medication and regular checkups [9].…”

Improving Medication Adherence Through Adaptive Digital Interventions (iMedA) in Patients With Hypertension: Protocol for an Interrupted Time Series Study

“…Intrinsic factors include demographics such as age and income [17,18]. Psychological determinants include perceived susceptibility [19,20] and trust in the care provider [21,22], and behavioral factors include forgetfulness [19,23], employment, and travel [23]. External factors include the number of medications prescribed [18], availability of prescribed medication [23], and family support [18].…”