Factors Influencing Medication Adherence among Hypertensive Patients: A Cross-Sectional Study in a Southwest Nigerian Public Hospital

Abstract

Introduction: Hypertension remains a major public health challenge, and effective management depends on consistent medication adherence. In many low- and middle-income settings, adherence is influenced by a complex mix of sociodemographic, economic, and health-system factors. This study assessed the socio-demographic and healthcare-related barriers that shape medication adherence behaviours among hypertensive patients. Methods: A cross-sectional descriptive design was employed and fisher’s formula was used to recruit 400 hypertensive patients through purposive sampling. Data were collected using a structured questionnaire and analyzed using SPSS version 25. Chi-square tests were used to determine associations between adherence levels and selected sociodemographic and clinical variables. Results: Most respondents were aged 51–60 years (24.8%), predominantly female (61.8%), and largely of Yoruba ethnicity (76.8%). Majority were married (54.3%), self-employed (54.3%), and had primary education (32.8%). Overall, there was moderate level of medication adherence (76.8%), with 13.5% demonstrating high adherence and 9.8% showing low adherence. Key barriers to adherence included unaffordable and inaccessible medications (76.3%), lack of comprehensive treatment information (77.0%), long waiting times (61.5%), forgetfulness (57.2%), uncooperative health workers (55.0%), unavailability of medications (55.0%), prolonged medication use (54.3%), and multiple medical conditions (52.8%). Statistical analysis showed significant associations between adherence and age (p = 0.03), sex (p = 0.00), ethnicity (p = 0.00), religion (p = 0.00), marital status (p = 0.00), occupation (p = 0.00), educational level (p = 0.01), and hypertensive status (p = 0.00). Conclusion: Strategic interventions that consider demographic differences, promote inclusive decision-making, and improve patient–provider communication is essential. Efforts should focus on enhancing access to affordable medications, reducing long waiting times, and ensuring consistent availability of antihypertensive drugs.