Adherence to Hypertensive Medication among Hypertensive Patients Aged ≥ 35 Years Old Attending Muhima District Hospital, Rwanda

The burden of hypertension is estimated to be over nine million globally. The drain associated with hypertension is worsened by poor medication adherence, among other factors. Medication nonadherence in hypertensive patients is a complex problem that results in enormous health and economic burdens. In Africa, medication adherence is reported as low as 37.5%, while the global rate remains at 45.3%. Therefore, this study was conducted to determine the prevalence and factors associated with adherence to antihypertensive medication among hypertensive patients at Muhima District Hospital, Rwanda. Ministry of Health, Muhima District Hospital and other stakeholders may use these findings to plan and develop evidence-based health interventions to promote adherence to antihypertensive medication. A cross-sectional study was conducted among 272 patients attending NCD service at Muhima District Hospital of Rwanda. A systematic sampling technique was employed to recruit participants. A study questionnaire was used to collect quantitative data. Descriptive analysis (frequencies, mean and percentages), bivariate analysis (Chi-square test with α=0.05) and Poisson logistic regression (AOR and 95% CI) were computed by using SPSS v21.0. The majority of the patients (59.2%) were 55 years and older, with a mean (±SD) of 55.8 (9.9) years. More than half of the participants, 159 (58.5%), were females. This study revealed that prevalence of adherence to antihypertensive medication among participants was 70.6%. Patient-related factors with significant association with adherence included patients who had no problems affording your antihypertensive medication [AOR 1.15, CI (1.03 - 1.28), p=0.011], no problems of transport to go for appointment [AOR 1.15, CI (1.06 - 1.25), p<0.001], patient who never stopped taking their medication due to fear of adverse effect [AOR 1.65, CI (1.51 - 1.81), p<0.0001]. Patient belief that some medications are expensive [AOR 1.08, CI= (1.01 - 1.15), p=0.021 is the only healthcare delivery factor significantly associated with adherence to antihypertensive medication. Therefore, the Ministry of Health, Muhima DH and other stakeholders are recommended to ensure that antihypertensive medications are always available and affordable cost at the hospital’s pharmacy and conduct comprehensive information education communication sessions for hypertensive patients so that they understand the complications of nonadherence to medication.