Abstract
To assess the prevalence and predictors of non-adherence to clinic appointments in adult patients with poorly controlled hypertension. A descriptive cross-sectional study. A primary care setting (family medicine clinic) overseen by family physicians in Kano, Nigeria. Two hundred and thirty-four randomly selected patients, aged ≥ 18 years with a diagnosis of hypertension, who had been on treatment for ≥1 year and had a current blood pressure of ≥140/90 mmHg were included. Non-adherence to clinic appointment among participants. Participants' mean age was 55±12.2 years (range: 23-85 years); they were predominantly females (163, 69.7%). Sixty (25.6%) participants were non-adherent to clinic-appointments. Being employed (OR [Odds ratio] =2.92, 95%CI [confident interval] =1.52-5.65, P=0.002), inability of participants or their children to pay the medical bills (OR=2.92,95%CI=1.42-6.00, P=0.004), and systolic blood pressure (SBP) of <160mmHg (OR=0.43, 95%CI=0.22-0.86, P=0.018) were predictors of clinic appointment non-adherence. The prevalence of non-adherence to clinic appointments was high. Being employed, patients or their children's inability to pay medical bills, and higher SBP were predictors of non-adherence to clinic appointments. Therefore, more studies are needed on effective interventions to reduce non-adherence to clinic appointments in this setting.
Highlights
This study examined the prevalence and predictors of non-adherence to clinic appointments among patients with poorly controlled hypertension in a Nigerian primary care setting
It found a clinic appointment non-adherence rate of 25.6%. Factors such as being employed, patient's or their children's inability to pay medical bills, and current systolic blood pressure of ≥160 mmHg were the predictors of non-adherence to clinic appointments
About a quarter of our study participants (25.6%) were non-adherent to clinic appointments. This finding was less than the prevalence of 31% found in a retrospective 12-month clinic attendance chart review of hypertensive patients attending a community health centre. It was higher than the 20% reported among medical inpatients with severe hypertension in the US,[18,19] and the 16.7% reported in hypertensive medical outpatients in Ibadan, Southwestern Nigeria.[17]
Summary
To assess the prevalence and predictors of non-adherence to clinic appointments in adult patients with poorly controlled hypertension.
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