Factors influencing non-compliance with anti-hypertensive drug therapy in Nigerians.

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Amira, C.O.
Okubadejo, N.U.
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National Postgraduate Medical College of Nigeria
BACKGROUND: Non-compliance with antihypertensive drug therapy can have a negative impact on cardiovascular outcome. The objective of this study was to determine compliance rate with anti-hypertensive therapy and factors affecting compliance among patients attending a Nigerian tertiary hospital. METHODS: A cross sectional study was conducted on 225 black hypertensive patients attending a tertiary clinic in Lagos, Nigeria. Demographic data, current anti-hypertensive therapy, compliance with prescribed therapy, factors affecting compliance and BP were documented via an investigator administered questionnaire and open-ended interviews. RESULTS: In this study, 77(34.2%) of the hypertensive patients were non-compliant. Blood pressure control was significantly better among compliant patients (45.9%) than in non-compliant patients (27.3%) (x(2) = 7.35 p=0.007). Gender, age, number of drugs used, educational level and presence of co-morbidities did not affect compliance. The major reasons for non-compliance were miscellaneous factors (60%) related to both patient's attitudes and beliefs (reflecting ignorance),and consultation failure on the part of clinicians. Lack of finances and side effects of medications accounted for 23.8% and 16.2% of non-compliances respectively. CONCLUSION: Although lack of finances is the single most self reported reason, miscellaneous factors related to patients' attitudes and belief contribute frequently. Incorporating patient education and counselling in routine follow-up may improve compliance, BP control, and ultimately impact positively on cardiovascular outcome.
Hypertension , Antihypertensives , Non compliance , Blood pressure control , Nigeria , Drug treatment
Amira CO, Okubadejo NU. Factors influencing non-compliance with anti-hypertensive drug therapy in Nigerians. Niger Postgrad Med J. 2007 Dec;14(4):325-9.