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Pedro Pallangyo,1,2 Makrina Komba,1 Zabella S Mkojera,1 Peter R Kisenge,1,2 Smita Bhalia,2 Henry Mayala,3 Engerasiya Kifai,3 Mwinyipembe K Richard,2 Khuzeima Khanbhai,1,2 Salma Wibonela,4 Jalack Millinga,4 Robert Yeyeye,4 Nelson F Njau,3 Thadei K Odemary,3 Mohamed Janabi2 1Unit of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania; 2Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania; 3Directorate of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania; 4Directorate of Nursing, Jakaya Kikwete Cardiac Institute, Dar es Salaam, TanzaniaCorrespondence: Pedro Pallangyo, Unit of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania, Email pedro.pallangyo@gmail.comBackground: Notwithstanding the availability of effective treatments, asymptomatic nature and the interminable treatment length, adherence to medication remains a substantial challenge among patients with hypertension. Suboptimal adherence to BP-lowering agents is a growing global concern that is associated with the substantial worsening of disease, increased service utilization and health-care cost escalation. This study aimed to explore medication adherence and its associated factors among hypertension outpatients attending a tertiary-level cardiovascular hospital in Tanzania.Methods: The pill count adherence ratio (PCAR) was used to compute adherence rate. In descriptive analyses, adherence was dichotomized and consumption of less than 80% of the prescribed medications was used to denote poor adherence. Logistic regression analyses was used to determine factors associated with adherence.Results: A total of 849 outpatients taking antihypertensive drugs for ≥ 1 month prior to recruitment were randomly enrolled in this study. The mean age was 59.9 years and about two-thirds were females. Overall, a total of 653 (76.9%) participants had good adherence and 367 (43.2%) had their blood pressure controlled. Multivariate logistic regression analysis showed; lack of a health insurance (OR 0.5, 95% CI 0.3– 0.7, p< 0.01), last BP measurement > 1 week (OR 0.6, 95% CI 0.4– 0.8, p< 0.01), last clinic attendance > 1 month (OR 0.4, 95% CI 0.3– 0.6, p< 0.001), frequent unavailability of drugs (OR 0.6, 95% CI 0.3– 0.9, p = 0.03), running out of medication before the next appointment (OR 0.6, 95% CI 0.4– 0.9, p = 0.01) and stopping medications when asymptomatic (OR 0.6, 95% CI 0.4– 0.8, p< 0.001) to be independent associated factors for poor adherence.Conclusion: A substantial proportion of hypertensive outpatients in this tertiary-level setting had good medication adherence. Nonetheless, observed suboptimal blood pressure control regardless of a fairly satisfactory adherence rate suggests that lifestyle modification plays a central role in hypertension management.Keywords: medication adherence, nonadherence, drug adherence, hypertension, blood pressure control |
