Abstract
BackgroundHypertension remains a public health challenge worldwide. In the Democratic Republic of Congo, its prevalence has increased in the past three decades. Higher prevalence of poor blood pressure control and an increasing number of reported cases of complications due to hypertension have also been observed. It is well established that non-adherence to antihypertensive medication contributes to poor control of blood pressure. The aim of this study is to measure non-adherence to antihypertensive medication and to identify its predictors.MethodsA cross-sectional study was conducted at Kinshasa Primary Health-care network facilities from October to November 2013. A total of 395 hypertensive patients were included in the study. A structured interview was used to collect data. Adherence to medication was assessed using the Morisky Medication Scale. Covariates were defined according to the framework of the World Health Organization. Logistic regression was used to identify predictors of non-adherence.ResultsA total of 395 patients participated in this study. The prevalence of non-adherence to antihypertensive medication and blood pressure control was 54.2 % (95 % CI 47.3–61.8) and 15.6 % (95 % CI 12.1–20.0), respectively. Poor knowledge of complications of hypertension (OR = 2.4; 95 % CI 1.4–4.4), unavailability of antihypertensive drugs in the healthcare facilities (OR = 2.8; 95 % CI 1.4–5.5), lack of hypertensive patients education in the healthcare facilities (OR = 1.7; 95 % CI 1.1–2.7), prior experience of medication side effects (OR = 2.2; 95 % CI 1.4–3.3), uncontrolled blood pressure (OR = 2.0; 95 % CI 1.1–3.9), and taking non-prescribed medications (OR = 2.2; 95 % CI 1.2–3.8) were associated with non-adherence to antihypertensive medication.ConclusionThis study identified predictors of non-adherence to antihypertensive medication. All predictors identified were modifiable. Interventional studies targeting these predictors for improving adherence are needed.
Highlights
Hypertension remains a public health challenge worldwide
Design From October 2013 to November 2013, a cross-sectional study was carried out at Kinshasa Primary Health-care (KPHC) network facilities. This network consists of 51 facilities that allows for follow-up of patients with non communicable diseases (NCDs) like hypertension and diabetes, living in Kinshasa [16]
This study found a high prevalence of Non-adherence to antihypertensive medication (NAM) and a poor control of blood pressure
Summary
Hypertension remains a public health challenge worldwide. Higher prevalence of poor blood pressure control and an increasing number of reported cases of complications due to hypertension have been observed. It is well established that non-adherence to antihypertensive medication contributes to poor control of blood pressure. Hypertension (HTN) remains a public health challenge worldwide because of its high prevalence and related complications. Uncontrolled HTN is one of the main cardiovascular risk factors (CVRF) [7] and based on the World Health Organization (WHO) estimates, at least 50 % of cardiovascular diseases (CVD) and 75 % of strokes are consequences of high blood pressure [8]. In the DRC, HTN-related complications including stroke, chronic kidney disease (CKD) are increasingly reported [9,10,11]
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