Predictors of non-adherence to antihypertensive medications: A cross-sectional study from a regional hospital in Afghanistan

Muhammad Haroon Stanikzai, Mohammad Hashim Wafa, Essa Tawfiq, Massoma Jafari, Cua Ngoc Le, Abdul Wahed Wasiq, Bilal Ahmad Rahimi, Ahmad Haroon Baray, Temesgen Anjulo Ageru and Charuai Suwanbamrung

PLOS ONE, 2023, vol. 18, issue 12, 1-15

Abstract: Background: Non-adherence to antihypertensive medications (AHMs) is a widespread problem. Cardiovascular morbidity and mortality reduction is possible via better adherence rates among hypertensive patients. Objectives: This study aimed to assess the prevalence of non-adherence to AHMs and its predictors among hypertensive patients who attended Mirwais Regional Hospital in Kandahar, Afghanistan. Methods: A cross-sectional study using random sampling method was conducted among hypertensive patients, aged ≥18 years in Mirwais Regional Hospital at a 6-month follow-up between October and December 2022. To assess non-adherence to AHMs, we employed the Hill-Bone Medication Adherence scale. A value below or equal to 80% of the total score was used to signify non-adherence. A multivariable binary logistic regression model was used to identify predictors of non-adherence to AHMs. Results: We used data from 669 patients and found that 47.9% (95%CI: 44.1–51.8%) of them were non-adherent to AHMs. The majority (71.2%) of patients had poorly controlled blood pressure (BP). The likelihood of non-adherence to AHMs was significantly higher among patients from low monthly-income households [Adjusted odds ratio (AOR) 1.70 (95%CI: 1.13–2.55)], those with daily intake of multiple AHMs [AOR 2.02 (1.29–3.16)], presence of comorbid medical conditions [AOR 1.68 (1.05–2.67), lack of awareness of hypertension-related complications [AOR 2.40 (1.59–3.63)], and presence of depressive symptoms [AOR 1.65 (1.14–2.38)]. Conclusion: Non-adherence to AHMs was high. Non-adherence to AHMs is a potential risk factor for uncontrolled hypertension and subsequent cardiovascular complications. Policymakers and clinicians should implement evidence-based interventions to address factors undermining AHMs adherence in Afghanistan.

Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0295246

DOI: 10.1371/journal.pone.0295246

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