ABSTRACT

Background: Medication non-adherence remains a major challenge in the management of chronic diseases such as diabetes and hypertension, leading to poor clinical outcomes, increased complications, and higher healthcare costs. Despite the availability of effective treatments, many patients fail to adhere to prescribed regimens due to various patient-related and systemic factors.

Objectives: This study aimed to assess the knowledge, medication-taking practices, and factors influencing long-term medication non-adherence among adult patients with diabetes and hypertension at La Quintinie Hospital, Douala.

Methods: A quantitative cross-sectional study design was used involving 100 adult patients diagnosed with diabetes and/or hypertension. Data were collected using a structured questionnaire and analysed using descriptive statistics such as frequencies and percentages.

Results: The findings revealed that respondents had relatively good knowledge, with 88% aware that the diseases require lifelong treatment and 92% knowing the complications of non-adherence. However, misconceptions existed, as 40% believed the diseases could be cured. Medication-taking practices were suboptimal, with only 46% always adhering to prescribed treatment, 59% reporting forgetfulness, and 78% stopping medication when they felt better. Major factors influencing non-adherence included high cost of medication (67%), lack of money (56%), drug unavailability (45%), and fear of side effects (47%).

Conclusion: Although patients demonstrated moderate knowledge, medication adherence was poor and influenced by multiple economic, behavioural, and health system factors. Targeted interventions focusing on patient education, affordability of drugs, and improved healthcare services are essential to enhance adherence and health outcomes.

Keywords: Medication adherence, diabetes, hypertension, knowledge, medication practices, non-adherence, Cameroon.

CHAPTER ONE

INTRODUCTION

• Background to the Study

Medication adherence is essential in the effective management of chronic diseases such as diabetes and hypertension. Globally, non-communicable diseases (NCDs) are responsible for a significant proportion of morbidity and mortality, with poor medication adherence contributing greatly to disease complications and deaths. Studies estimate that adherence to long-term therapy for chronic illnesses in developed countries averages only about 50%, and this rate is even lower in developing countries (Khayyat et al., 2019). Poor adherence leads to uncontrolled blood pressure and blood glucose levels, increasing the risk of cardiovascular diseases, stroke, kidney failure, and premature death (Chantzaras & Yfantopoulos, 2025). Furthermore, medication non-adherence increases healthcare costs due to frequent hospitalisations and disease complications (Nakajima et al., 2021).

In Africa, the burden of diabetes and hypertension is rising rapidly due to urbanisation, lifestyle changes, and ageing populations. Evidence shows that hypertension prevalence in Africa ranges between 25% and 35% among adults, while diabetes prevalence is also increasing steadily across the continent (Atinga et al., 2018). Despite this growing burden, medication adherence remains a major challenge. Studies conducted in African countries indicate that a large proportion of patients with chronic diseases do not follow their prescribed treatment regimens. For example, research in Ghana and Ethiopia found significant levels of medication non-adherence among patients with diabetes and hypertension, largely influenced by factors such as low knowledge, financial constraints, and poor healthcare access (Atinga et al., 2018; Araya et al., 2020). These challenges are further compounded by weak health systems and limited patient education programs.

In Cameroon, chronic diseases such as hypertension and diabetes are becoming major public health concerns. The prevalence of hypertension has been reported to range from 24% to 31% among adults, while diabetes affects approximately 6% of the population (Akoko et al., 2017). Despite the availability of treatment, medication adherence remains suboptimal. Studies in different regions of Cameroon have shown that many patients lack adequate knowledge about their conditions and do not consistently take their medications as prescribed. For instance, Akoko et al. (2017) reported poor compliance among hypertensive patients in the Bamenda Health District, while Fonju (2015) identified multiple factors influencing adherence, including cost of medication, forgetfulness, and lack of awareness. These issues contribute to poor disease control and increased complications among patients.

At the study area, La Quintinie Hospital Douala, healthcare providers frequently manage patients with poorly controlled diabetes and hypertension, suggesting possible long-term medication non-adherence. As noted in this study, there is limited empirical data specifically assessing patients’ knowledge, medication-taking practices, and the factors influencing long-term non-adherence in this setting. Understanding these factors is essential for designing targeted interventions that can improve adherence, enhance disease management, and reduce complications among patients receiving care at the hospital.

1.2 Statement of Problem

Medication non-adherence remains a major challenge in the management of chronic conditions such as diabetes and hypertension, leading to poor clinical outcomes and increased risk of complications. Despite the availability of effective pharmacological treatments, many adult patients do not adhere to prescribed regimens, resulting in uncontrolled blood glucose and blood pressure, as well as a higher incidence of cardiovascular diseases, hospitalisations, and premature mortality. In Cameroon, evidence indicates that a considerable proportion of patients with chronic illnesses exhibit poor adherence, contributing to recurrent complications and increased pressure on already limited healthcare resources.

Although several interventions, such as patient education, treatment simplification, and routine follow-up, have been introduced to improve adherence, the problem persists. This is largely because these strategies often fail to adequately address the complex and interrelated factors influencing non-adherence, including patients’ knowledge gaps, poor medication-taking practices, socioeconomic constraints, and health system challenges.

At La Quintinie Hospital Douala, healthcare providers frequently encounter patients with poorly controlled diabetes and hypertension, suggesting possible long-term medication non-adherence. However, there is limited empirical data assessing patients’ knowledge, practices, and the specific factors influencing non-adherence in this local context. Therefore, this study aims to assess the knowledge, practices, and factors influencing long-term medication non-adherence among adult patients with diabetes and hypertension at La Quintinie Hospital, Douala, to generate evidence for targeted interventions to improve adherence and health outcomes.

1.3 Research Questions

1. What is the level of knowledge of adult patients regarding diabetes and hypertension, and their treatment?
2. What are the medication adherence practices among adult patients with diabetes and hypertension?
3. What factors influence long-term medication non-adherence among these patients?

Read More: Nursing Project Topics with Materials