Key result
Cost-free access to antihypertensives is associated with an extremely low ~11% treatment adherence rate.
Why the study?
The level and predictors of medication adherence had not been examined among populations with cost-free access to treatment, particularly in the Ghanaian healthcare setting.
Cross-Sectional (n=253)
No
Despite cost-free access to antihypertensive medications, adherence remains extremely low (11.1%), highlighting the critical role of non-cost barriers such as accessibility, busy schedules, and time spent at the facility.
Answers are grounded in this paper and cite their sources.
Non-cost barriers may underlie low adherence despite free access; challenges cost-focused consensus while leaving causal targets open for prospective trials.
The level and predictors of medication adherence have not been given attention among populations for whom the cost of treatment is not a concern, especially in the Ghanaian healthcare setting. This study compared generalised linear models to determine the factors associated with adherence to treatment among hypertensive patients with a workplace policy that offers cost-free access in Ghana. We conducted a cross-sectional descriptive study to investigate the level of adherence and factors that influence practice among hypertensive patients with cost-free access to treatment. A total of 254 respondents were conveniently sampled and administered a questionnaire. The predictors of treatment adherence were assessed using Bivariate and generalised linear models (logistic and complementary log-log regression models). The complementary log-log regression model outperformed the logistic regression model in fitting the relationships in the data, by reporting lower AIC and BIC, and higher Nagelkerke and Cox and Snell pseudo-R-squared values. Most (88.9%) respondents scored low adherence, and only 11.1% adhered to treatment. The factors that affect adherence to hypertension medication included age (ARR = 8.58, 95%CI 1.23-83.28, p-value = 0.031), sex (ARR = 0.19, 95%CI 0.03-0.91, p-value = 0.042), location (ARR = 10.78, 95%CI 2.01-79.76, p-value = 0.007), busy schedule (ARR = 0.03, 95%CI 0.00-0.30, p-value = 0.016), time spent (ARR = 0.05, 95%CI 0.00-0.28, p-value = 0.002) and accessibility (ARR = 17.89, 95%CI 4.03-112.38, p-value < 0.001). The high level of non-adherence to treatment among patients, even when the cost of treatment is not a barrier, could contribute to overall treatment outcomes. Despite cost-free access, adherence remains low, highlighting the need for further investigation into non-cost barriers affecting treatment compliance. In addition, there is a need to design and implement measures to improve adherence among patients with hypertension in the country.
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Nyande et al. (2026) conducted a cross-sectional in Hypertension (n=253). Hypertensive medication vs. null was evaluated on Adherence to hypertension treatment (ARR 8.58, 95% CI 1.23–83.28, p=0.031). The adherence to hypertension treatment among patients with cost-free access is extremely low at 11.1%.
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