Factors associated with poor adherence to medication among hypertensive patients in twelve low and middle income Sub-Saharan countries

Diane Macquart de Terline, Adama Kane, Kouadio Euloge Kramoh, Ibrahim Ali Toure, Jean Bruno Mipinda, Ibrahima Bara Diop, Carol Nhavoto, Dadhi M Balde, Beatriz Ferreira, Martin Dèdonougbo Houenassi, Méo Stéphane Ikama, Samuel Kingue, Charles Kouam Kouam, Jean Laurent Takombe, Emmanuel Limbole, Liliane Mfeukeu Kuate, Roland N’guetta, Jean Marc Damorou, Zouwera Sesso, Abdallahi Sidy Ali, Marie-Cécile Perier, Michel Azizi, Jean Philippe Empana, Xavier Jouven and Marie Antignac

PLOS ONE, 2019, vol. 14, issue 7, 1-14

Abstract: Introduction: Over the past few decades, the prevalence of hypertension has dramatically increased in Sub-Saharan Africa. Poor adherence has been identified as a major cause of failure to control hypertension. Scarce data are available in Africa. Aims: We assessed adherence to medication and identified socioeconomics, clinical and treatment factors associated with low adherence among hypertensive patients in 12 sub-Saharan African countries. Method: We conducted a cross-sectional survey in urban clinics of both low and middle income countries. Data were collected by physicians on demographics, treatment and clinical data among hypertensive patients attending the clinics. Adherence was assessed by questionnaires completed by the patients. Factors associated with low adherence were investigated using logistic regression with a random effect on countries. Results: There were 2198 individuals from 12 countries enrolled in the study. Overall, 678 (30.8%), 738 (33.6%), 782 (35.6%) participants had respectively low, medium and high adherence to antihypertensive medication. Multivariate analysis showed that the use of traditional medicine (OR: 2.28, 95%CI [1.79–2.90]) and individual wealth index (low vs. high wealth: OR: 1.86, 95%CI [1.35–2.56] and middle vs. high wealth: OR: 1.42, 95%CI [1.11–1.81]) were significantly and independently associated with poor adherence to medication. In stratified analysis, these differences in adherence to medication according to individual wealth index were observed in low-income countries (p

Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0219266

DOI: 10.1371/journal.pone.0219266

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