Medication adherence and associated factors among hypertensive patients attending medical clinics at Teaching Hospital Jaffna

Abstract

Hypertension is a major global public health challenge, with an increasing prevalence in developing countries such as Sri Lanka. Uncontrolled hypertension affects multiple body systems and leads to serious complications. Medication adherence plays a crucial role in achieving optimal blood pressure control, preventing complications, and improving clinical outcomes. Identifying factors associated with medication adherence is essential for developing effective strategies to improve adherence. This study aimed to assess medication adherence and its associated factors among hypertensive patients attending medical clinics at Teaching Hospital Jaffna. A descriptive cross-sectional study was conducted among 224 hypertensive patients attending the medical clinic at Teaching Hospital Jaffna in November 2022. Data were collected using a pretested interviewer-administered questionnaire to assess socio-demographic characteristics and medication adherence, while treatment-related factors were obtained using a data extraction sheet. Medication adherence was assessed using the Morisky Medication Adherence Scale-8 (MMAS-8) and categorized into good and poor adherence. Associations between adherence and selected factors were analyzed using the Chi-square test. All 224 selected participants were interviewed, yielding a response rate of 100%. The majority were male (64.7%), and the mean age was 64.5 years (SD = 9.6). Good medication adherence was observed in 46.4% of participants, while 53.6% had poor adherence. The mean MMAS-8 score was 5.9 out of 8. Medication adherence showed a significant association with marital status (p = 0.03), frequency of alcohol consumption (p = 0.02), state of hypertension control (p = 0.02), and number of clinic visits during the previous three months (p = 0.04). A negative association was identified between adherence and frequency of alcohol drinking (OR = 0.21). Forgetfulness was the most commonly reported reason for poor adherence. In conclusion, less than half of the hypertensive patients demonstrated good medication adherence. Several socio-demographic and clinical factors influenced adherence, highlighting the need for targeted interventions to improve medicationtaking behavior among hypertensive patients.