Assessment of Adherence And Its Contributing Factors Among Hypertension Patients In Eritrea

This cross-sectional survey study was conducted on one hundred patients who were interviewed as they visited a hospital and community pharmacies to refill their prescriptions. The study was conducted from September to December 2013. Patients' age of 18-90, who had been taking anti-hypertensive drugs for at least one month, who could understand the languages Tigrinia & Tigre were included. Severely sick, mentally ill and patients with hearing and communication disabilities were excluded. The mean difference in the two groups was compared using chi square test. Binary logistic regression analysis was used to calculate the relationship strength between adherence and its contributing factors. Out of 100 respondents, 68% were having 'good adherence', the rest 32% were 'poor adherents'. The ensuing factors are reported for being a positive influence on adherence: age (older adults, B = 2.219, p = 0.03), number of pills (monotherapy, B = 1.25, p = 0.03), medical checkup (Often, B = 1.87, p = 0.03), education (illiterate, B = 1.22, 0.04), employment (unemployed, B = 1.212, p = 0.05) marital status (married, B = 1.547, p = 0.05) and BP control (controlled patients, B = 2.241, p = 0.04). On the other hand, gender (male/female B = 1.187/0.843, p = 0.4), income (salaried/not salaried, B = 0.939/1.065, p = 0.3), treatment duration (< 5 yrs/5& above B = 0.977/1.023, p = 0.4), payment (government/self, 1.383/0.723, p = 0.2) and family history (yes/no, B = 1.533/0.652, p = 0.09) did not show any remarkable relationship with good adherence. Patients' knowledge about HTN and its treatment was evaluated as one of the components of contributing factors. Surprisingly, the least knowledgeable subjects were good adherents and as the knowledge increases the adherence somehow decreases to moderate to poor. There were many reasons for missing doses and forgetting to take medication was reported as a first reason in a frequency hierarchy. This study reported a high proportion of good medication adherence. However, patients with poor adherence should be more closely monitored and appropriate medication counseling must be given to optimize their drug taking behavior.