Determinants of adherence to antihypertensive therapy among hypertensive patients attending government hospitals at Sunyani Municipality, Ghana: a quantitative cross-sectional study

Abstract

Hypertension is the leading cause of cardiovascular complications and death. This impact can only be minimized or prevented by adhering to antihypertensive therapy. However, in developing countries, patients with hypertension have a high nonadherence to antihypertensive therapy. This study aimed to investigate the determinants of adherence to antihypertensive therapy among hypertensive patients attending government hospitals in Ghana’s Sunyani Municipality. A cross-sectional quantitative study was conducted between March and April 2024 at Sunyani Teaching and Sunyani Municipal Hospitals. 273 adult hypertensive outpatients were selected using simple random sampling, with sample sizes allocated via proportionate sampling based on 2022 patient volume. Structured questionnaires measuring sociodemographic factors, hypertension knowledge, attitudes, and treatment adherence were administered in person. Data were cleaned in Excel and analyzed in SPSS (v25.0) using chi-square tests and binary logistic regression ( p < 0.05) to determine predictors of adherence.The limitations of this study include the use of self-reported data, which is vulnerable to participants’ responses and memory recall biases. Additionally, the cross-sectional study design used cannot determine cause-and-effect relationships, but rather associations between variables. Most (85%) participants did not adhere to their antihypertensive therapy. The determinants of adherence to antihypertensive therapy were patients’age and knowledge of hypertension. Compared to patients aged ≥ 60, patients aged 36–49 were 3.85 times more likely to adhere to their therapy. Additionally, compared with patients with good knowledge of hypertension, patients with poor knowledge were 6.64 times more likely to adhere to therapy. Patients aged ≥ 60 years and those with good knowledge of hypertension were more likely to be non-adherent to antihypertensive therapy. This may be because patients with good knowledge may feel more confident in modifying or discontinuing medications based on perceived symptom improvement or concerns about adverse effects. In contrast, those with poor knowledge may place considerable trust in healthcare providers and comply with prescribed medications without questioning treatment decisions or disobeying clinicians because of their cultural obedience to authority. The majority of participants in this study were non-adherent to their therapy; therefore, the Ghana Health Service including prescribers and nurses should embark on a series of health education programs on radio and other media agencies should continuously remind both patients and residentsabout the consequences of non-adherence to antihypertensive therapy.

The authors' abstract, as published at the source. BMC Cardiovascular Disorders, 2026 · DOI ↗