Predictors of nonadherence to antihypertensive medications among stroke survivors in Benin City Nigeria

Abstract

Background: Hypertension is the single most important modifiable risk factor for developing stroke and its recurrence. Evidence suggests that antihypertensive treatment rates following stroke remain poor worldwide and non-adherence to secondary preventive medication is a disturbing clinical problem associated with recurrence and poor outcomes. Aim: The aim of this study was to determine the predictors of non-adherence to antihypertensive medications among stroke survivors 3 months after their stroke. Materials and methods: This was a cross-sectional study, involving stroke survivors attending the out-patient neurology clinic at the University of Benin Teaching Hospital, Benin City, 3 months after their stroke. Demographic and clinical characteristic were obtained, with a questionnaire, while medication adherence was measured by pill count method. In the final logistic regression analysis, the independent variables were age, gender, educational status, marital status, modified Rankin scale, polypharmacy, and types of stroke while medication non-adherence was the dependent variable. Results: One hundred and twelve stroke survivors participated. There were 58(51.8%) males and the mean age was 72(12) years. The non-adherence rate in this study was 57.1 %(64/112). The significant predictors of non-adherence to antihypertensive medications were the female gender (P = 0.009), severe disability (P = 0.003), the older participants (P = 0.004), and polypharmacy (P = 0.002). Conclusion: Non-adherence to antihypertensive drugs following stroke was observed in our study, which would affect blood pressure control leading to stroke recurrence. To prevent recurrent strokes, stroke survivors must adhere to their antihypertensive drugs, while involving patient and family members in decision making with regards to treatment plans.