Key result
Multilevel patient, therapy, and healthcare system factors drive medication adherence barriers, providers report.
Why the study?
Medication adherence remains suboptimal among patients with comorbid hypertension and diabetes mellitus, particularly in low- and middle-income settings where multiple factors influence medication-taking behavior.
Healthcare providers identified interacting patient, therapy, condition, socio-economic, and health system factors as key drivers of medication adherence in comorbid hypertension and diabetes, emphasizing the need for multidisciplinary care and mental health support.
May inform tailored adherence strategies in comorbid hypertension and diabetes; hypothesis-generating for testing multidisciplinary interventions in prospective studies.
Background and Aims: Medication adherence is a critical determinant of clinical outcomes among patients with comorbid hypertension and diabetes mellitus. Despite the availability of effective therapies, adherence remains suboptimal, particularly in low- and middle-income settings where multiple patient, treatment, and health system factors influence medication-taking behavior. Healthcare providers are uniquely positioned to identify barriers and facilitators to adherence. This study explored healthcare providers' perspectives on medication adherence among patients with comorbid hypertension and diabetes using the World Health Organization multidimensional adherence framework. Methods: An exploratory descriptive qualitative study was conducted at the Pentecost Hospital, Ghana, between March and May 2025. Fifteen healthcare providers involved in the management of patients with hypertension and diabetes were purposively sampled, including medical officers, nurses, pharmacist, pharmacy technicians, dietitians, physician assistants, and mental health practitioners. Data were collected through semi-structured in-depth interviews lasting 30-60 min and analyzed using thematic analysis following Braun and Clarke's six-step framework. Results: = 11) had 1-6 years of professional experience. Five major themes were identified: patient-related, therapy-related, condition-related, socio-economic, and healthcare system-related factors. Key barriers included forgetfulness, intentional dose modification, symptom-driven discontinuation, cultural and religious beliefs about medicines, polypharmacy, medication side effects, fear of complications, anxiety, and medication costs. Facilitators included reminder systems, family and carer support, patient education, and multidisciplinary collaborative care. Participants emphasized the importance of integrating mental health services into chronic disease management. Conclusion: Healthcare providers perceived medication adherence as influenced by interacting patient, therapy, condition, socio-economic, and healthcare system factors. Interventions integrating patient education, family involvement, mental health support, and multidisciplinary care may support medication adherence and improve long-term clinical outcomes.
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Kwakye et al. (2026) studied Comorbid hypertension and diabetes (healthcare provider perspectives) (n=15). Management of patients with comorbid hypertension and diabetes was evaluated on Barriers and facilitators to medication adherence. Healthcare providers identified interacting patient, therapy, condition, socio-economic, and healthcare system factors as key barriers and facilitators to medication adherence.
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