Antihypertensive Medication Adherence among Patients in Tertiary Healthcare Facilities in Abuja, Nigeria: A Cross-sectional Study

Hypertension is a leading cause of cardiovascular morbidity and mortality worldwide, and long-term adherence to antihypertensive therapy is a key determinant of blood pressure control. Yet, the combination of factors associated with this behaviour in tertiary care settings is poorly characterised. This study examined the prevalence and correlates of antihypertensive medication adherence among patients attending three tertiary healthcare facilities in Abuja, Nigeria. A cross-sectional survey was conducted between 7 January and 15 May 2026 among adult hypertensive patients recruited by convenience sampling at three tertiary healthcare facilities in Abuja. A structured, self-administered questionnaire comprising an 8-item adherence scale adapted from the Morisky Medication Adherence Scale (MMAS-8), and study-specific perceived-barrier and patient-education scales was completed by 166 participants. Data were analysed using chi-square tests, Welch’s t-tests, and hierarchical binary logistic regression. Non-adherence (adherence score <6) was found in 68.1% of participants (95% CI: 61.0–75.2%). At bivariate analysis, adherence was associated with educational attainment, income, health insurance status, marital status, and distance to the facility (all p<0.05), but not with age, gender, duration of hypertension, or comorbidities. Non-adherent patients reported higher mean perceived-barrier scores (3.44 vs 1.63, p<0.001) and lower mean patient-education scores (3.58 vs 4.47, p<0.001) than adherent patients. Among socio-demographic and economic factors, tertiary education (AOR=3.59, 95% CI: 1.24–10.42), upper-bracket income (AOR=2.57, 95% CI: 1.08–6.13), and living within 10 km of the facility (AOR=2.98, 95% CI: 1.34–6.64) were independently associated with adherence. The patient-education score was associated with adherence after adjustment for these factors (AOR=2.91, 95% CI: 1.62–5.21). When the perceived-barrier score was added, it was the only factor that remained independently associated with adherence (AOR=0.12, 95% CI: 0.05–0.26). Non-adherence was highly prevalent among hypertensive patients attending the study facilities. Lower educational attainment, lower income, greater distance from the facility, and less favourable experiences of patient education were associated with non-adherence, and perceived barriers were the strongest correlate. Because of the cross-sectional design and convenience sample, these associations do not establish causality; interventions that address patients’ perceived barriers, strengthen patient education, and reduce cost and access barriers warrant evaluation in tertiary care settings.