Abstract

Hypertension is a major public health challenge, particularly in low-resource settings, where medication adherence remains a critical barrier to effective management. This study investigated the factors influencing medication adherence among hypertensive patients at Cite Verte District Hospital in Yaoundé, Cameroon.

A descriptive cross-sectional design was employed, with data collected from 50 hypertensive patients using a structured questionnaire. The Morisky Medication Adherence Scale (MMAS-8) was used to assess adherence levels, while socioeconomic, healthcare-related, and patient-related factors were analyzed.

Results revealed a strikingly low adherence rate of 32%, with 68% of patients classified as non-adherent. Key barriers included financial constraints (56% struggled to afford medication), forgetfulness (44%), medication shortages (50%), and poor provider communication (36%). Chi-square analysis identified significant predictors of non-adherence: forgetfulness (OR=4.50, p<0.001), medication costs (OR=2.85, p=0.011), and frequent drug shortages (OR=3.20, p=0.022). Additionally, 36% of patients skipped doses when asymptomatic, reflecting misconceptions about hypertension management.

The study shows that the multifaceted nature of non-adherence, driven by economic, systemic, and behavioral factors. Recommendations include subsidizing medication costs, improving healthcare delivery (e.g., reliable drug supply, structured follow-ups), and enhancing patient education to address knowledge gaps. These findings highlight the urgent need for targeted interventions to improve adherence and hypertension outcomes in resource-limited settings.

Keywords: Hypertension, Medication Adherence, Socioeconomic Barriers, Healthcare System, Patient-Related Factors.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Hypertension, commonly known as high blood pressure, has become a significant public health challenge worldwide. According to the World Health Organization (2021), over 1.28 billion adults globally suffer from hypertension, with the majority living in low- and middle-income countries. This chronic condition is a major risk factor for cardiovascular diseases, stroke, and kidney failure, contributing to millions of premature deaths each year. In sub-Saharan Africa, including Cameroon, the prevalence of hypertension has been rising steadily due to urbanization, unhealthy diets, and sedentary lifestyles (Ataklte et al., 2015).

Despite the availability of effective treatments, many hypertensive patients struggle to maintain consistent medication adherence. Studies indicate that poor adherence to antihypertensive therapy is a primary reason for uncontrolled blood pressure (Burnier et al., 2019). When patients fail to take their medications as prescribed, their risk of complications increases, leading to higher healthcare costs and reduced quality of life. This problem is particularly acute in resource-limited settings, where access to healthcare and medications is often inconsistent.

In Cameroon, hypertension management faces numerous challenges, including limited public awareness, financial barriers, and weak healthcare infrastructure (Mbuagbaw et al., 2012). Many patients cannot afford long-term medication, while others lack proper education about the importance of adherence. Additionally, cultural beliefs and stigma surrounding chronic illnesses sometimes discourage individuals from seeking or continuing treatment. These factors contribute to low adherence rates, undermining efforts to control hypertension effectively.

Several factors may influence medication adherence among hypertensive patients, including socioeconomic status, healthcare access, patient knowledge, and psychosocial support (Kretchy et al., 2014). For instance, financial constraints may prevent patients from purchasing medications, while forgetfulness or complex dosing schedules can lead to missed doses. Furthermore, poor communication between healthcare providers and patients may result in misunderstandings about treatment plans. Addressing these challenges requires a comprehensive approach that considers both individual and systemic barriers.

1.2 Statement of the problem

Hypertension remains a serious health issue in our community, with many patients failing to take their medications as prescribed. This poor adherence leads to uncontrolled blood pressure and preventable health complications. The problem stems from multiple challenges that need urgent attention.

Financial constraints pose a major barrier, as many patients struggle to afford their medications consistently. Transportation difficulties and limited health education further compound the problem, making it hard for patients to maintain their treatment routines. These economic and social factors create significant obstacles to proper healthcare access.

The healthcare system itself in Cameroon presents additional challenges. Patients often face long wait times at clinics and receive inadequate counselling about their medications. Frequent drug shortages and poor follow-up systems make consistent treatment even more difficult to maintain. These systemic issues discourage patients from adhering to their prescribed regimens. Personal factors also play a crucial role in medication non-adherence. Many patients forget to take their pills or stop when they feel better, not understanding the ongoing need for treatment. Cultural beliefs and fear of side effects further influence patients’ willingness to follow medical advice.

At Cite Verte District Hospital, there is limited understanding of the extent of medication adherence among hypertensive patients and the specific barriers they face in following their treatment plans, thus this study seeks to investigate the factors influencing medication adherence among patients with hypertension at Cite Verte District Hospital.

1.3 Significance of the study

The findings of the study would be of great significance to the following group of persons;

To Patients

This study will help patients understand why they may miss their hypertension medication. It will teach them how to follow their treatment better, improving their health and preventing complications.

To Family Members and Caregivers

The findings will show how families can support patients, such as reminding them to take their medicine. It will also help them learn why sticking to treatment is important for long-term health.

To the Hospital

The results will help the hospital improve its services, like offering cheaper medicines or better patient education. This can lead to better care for hypertensive patients.

To the Ministry of Health

The study will provide data to guide policies, such as making hypertension drugs more affordable. It can also help plan better health programs for the community.

To Nurses

Nurses can use the findings to educate patients and track their medication use. This will make their care more effective and improve patient outcomes.

To Future Researchers

This research will serve as a reference for other studies on hypertension treatment. It will also help test methods for measuring medication adherence.

1.4 Research questions

1.4.1 Main Question

What are the factors influencing medication adherence among patients with hypertension at Cite Verte District Hospital?

1.4.2 Specific Research Questions

1. What is the level of medication adherence among hypertensive patients attending Cite Verte District Hospital?
2. What are the key socioeconomic, healthcare-related, and patient-related factors influencing medication adherence among hypertensive patients in the hospital?

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