ASSOCIATION BETWEEN FAMILY RESOURCES AND DRUG ADHERENCE IN HYPERTENSIVE MANAGEMENT AT THE CHRONIC CARE CLINIC OF KOMFO ANOKYE TEACHING HOSPITAL

Abstract

Introduction

Hypertension is the commonest risk factor for cardiovascular diseases which is currently the leading cause of death globally. Of the almost 1.4 billion people with hypertension worldwide, 71.4% (one billion) are found in low and middle-income countries (LMIC) with the WHO Africa region having the highest current prevalence of hypertension. One of the strongest pillars in the multifactorial approach to the management of hypertension is improving medication adherence to antihypertensives. It is imperative that innovative ways be sought to achieve this goal among health practitioners and especially Family Physicians who aim to provide comprehensive care for any pathology including hypertension. Even though there is information on social determinants of health and their influence on medication adherence and hypertension, little is known about the effect of family resources on medication adherence in hypertension and consequently blood pressure control.

Aim To determine the relationship between Family Resources and Medication Adherence in patients with essential hypertension

Materials and Methods This was a cross-sectional study carried out at the Chronic Care Clinic of the Family Medicine Directorate at the Komfo Anokye Teaching Hospital. Systematic sampling was used to select 110 patients with essential hypertension attending the clinic. Patients were administered a questionnaire which incorporated the Morisky 8 adherence Scale, the SCREEM questionnaire for measuring family resources and general demographic data. Medical records of the patients were also assessed to obtain current and previous blood pressure control records. The information obtained was entered into epi-info, cleaned and transferred into STATA statistical software (Version 15). Basic demographic data and frequencies were extracted following which Chi square analysis and Fisher exact tests were conducted and multivariate regression performed on specific variables to assess relevant relationships. The results of the analysed data were then presented as frequencies in tables and charts.

Results A total of 110 patients with essential hypertension were enrolled in this study majority of whom were female (94, 85.5%), Christian (102, 92.7%), married (54, 49.1%) had basic education (84, 76.4%) and had uncontrolled blood pressure (65, 59.1%). Adequate family resources were reported by most respondents (85, 77.3%) with religious resources most reported as being available (89.1%) while the least available resource was economic (30.9%). The results also showed that married participants were more likely to have adequate family resources (p = 0.04) and Christians were more likely to report adequate social resources (p = 0.04). Majority of participants self-reported medium or high adherence to their antihypertensive medication (68.2%), however participant demographics had no influence on medication adherence or blood pressure control.

Conclusion The most available family resource was the religious resource with the least available resource being economic. Self- reported medication adherence was found to be adequate in majority of respondents, with 68.2% of respondents reporting either medium or adequate medication adherence. No association was found between family resources and medication adherence among respondents. It is imperative that further research be conducted to establish how to harness religious resources in the improvement of medication adherence. It is also recommended that other objective adherence measuring tools be used to assess for possible relationships between family resources and medication adherence in the control of essential hypertension.