Ghana study links hypertension knowledge to medication adherence

A quantitative cross-sectional study conducted in Ghana’s Sunyani Municipality has identified specific determinants influencing adherence to antihypertensive therapy among hypertensive patients. The research, published in BMC Cardiovascular Disorders, examined factors associated with treatment compliance in a population where nonadherence remains a significant public health concern. The findings suggest that patient age and knowledge of hypertension are key variables associated with adherence levels.

The study was conducted between March and April 2024 at two government facilities: Sunyani Teaching Hospital and Sunyani Municipal Hospital. Researchers selected 273 adult hypertensive outpatients using simple random sampling. To ensure the sample represented the patient population accurately, sample sizes were allocated via proportionate sampling based on 2022 patient volume data. The use of a cross-sectional design allowed for the assessment of associations between variables at a single point in time.

Data collection involved the administration of structured questionnaires in person. These instruments measured sociodemographic factors, hypertension knowledge, attitudes, and treatment adherence. Participants answered questions regarding their medication habits and their understanding of their condition. The data were subsequently cleaned in Microsoft Excel and analyzed using SPSS version 25.0. Statistical analysis included chi-square tests and binary logistic regression to identify predictors of adherence, with a significance level set at p < 0.05.

The primary finding of the study was that 85% of the participants did not adhere to their antihypertensive therapy. This high rate of nonadherence underscores the challenge of managing hypertension in this setting. Adherence to medication is crucial for minimizing the risk of cardiovascular complications and death, which are leading outcomes associated with uncontrolled hypertension. In developing countries, patients with hypertension often exhibit high levels of nonadherence, a trend confirmed by this study’s results.

Logistic regression analysis revealed that patients’ age and knowledge of hypertension were significant determinants of adherence. Compared to patients aged 60 years and older, those aged 36 to 49 were 3.85 times more likely to adhere to their therapy. This suggests that middle-aged patients may have different adherence patterns compared to older adults. Additionally, the study found a counterintuitive relationship between knowledge and adherence. Compared with patients who had good knowledge of hypertension, those with poor knowledge were 6.64 times more likely to adhere to therapy.

The authors proposed a potential explanation for the association between poor knowledge and higher adherence. They suggested that patients with good knowledge of hypertension might feel more confident in modifying or discontinuing medications based on perceived symptom improvement or concerns about adverse effects. In contrast, patients with poor knowledge may place considerable trust in healthcare providers. These patients may comply with prescribed medications without questioning treatment decisions, driven by cultural obedience to authority.

The study acknowledges several limitations that must be considered when interpreting the results. The use of self-reported data makes the findings vulnerable to participant response biases and memory recall issues. Furthermore, the cross-sectional design of the study means that it can only determine associations between variables, not cause-and-effect relationships. While the study identifies age and knowledge as predictors of adherence, it cannot definitively establish that these factors cause changes in adherence behavior.

Based on the findings, the authors recommend that the Ghana Health Service, including prescribers and nurses, implement health education programs. These programs should aim to address the high rates of nonadherence observed in the study. Additionally, media agencies should continuously remind patients and residents about the consequences of non-adherence to antihypertensive therapy. By leveraging radio and other media channels, public health campaigns can reinforce the importance of consistent medication use.

Subject of Research: Determinants of antihypertensive therapy adherence in Ghana

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

Article References: Dadzie, F., Asumah, M. N., Yeboah, R., Boah, M., & Aninanya, G. A. (2026). Determinants of adherence to antihypertensive therapy among hypertensive patients attending government hospitals at Sunyani Municipality, Ghana: a quantitative cross-sectional study. BMC Cardiovascular Disorders. https://doi.org/10.1186/s12872-026-06799-1

Image Credits: AI Generated

DOI: 10.1186/s12872-026-06799-1

Keywords: hypertension, medication adherence, Ghana, cross-sectional study, cardiovascular health, public health, health literacy, antihypertensive therapy, Determinants, adherence, antihypertensive, therapy