Blood Pressure Control, Accessibility, and Adherence to Antihypertensive Medications: Patients Seeking Care in Two Hospitals in the Ashanti Region of Ghana

Nana Ofori Adomako; Afia Frimpomaa Asare Marfo; Mercy Naa Aduele Opare-Addo; Nathaniel Nyamekye; Frances Thelma Owusu-Daaku

doi:10.1155/2021/9637760

Blood Pressure Control, Accessibility, and Adherence to Antihypertensive Medications: Patients Seeking Care in Two Hospitals in the Ashanti Region of Ghana

Int J Hypertens. 2021 Jul 15:2021:9637760. doi: 10.1155/2021/9637760. eCollection 2021.

Authors

Nana Ofori Adomako¹, Afia Frimpomaa Asare Marfo¹, Mercy Naa Aduele Opare-Addo¹, Nathaniel Nyamekye¹, Frances Thelma Owusu-Daaku¹

Affiliation

¹ Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Abstract

Hypertension is the second leading cause of death in Ghana, partly accounting for two-thirds of all medical admissions and more than 50% of deaths. This study aimed to comparatively evaluate adherence and accessibility to antihypertensive medications at two different levels of healthcare facilities in Kumasi, Ghana, and determine factors associated with medicine accessibility and adherence. A cross-sectional study involving outpatient department (OPD) hypertensive patients, 143 at KNUST Hospital (UHS) and 342 at Komfo Anokye Teaching Hospital (KATH), was conducted using a semistructured questionnaire. Correlations were drawn to evaluate the effect of accessibility and adherence on blood pressure control. A face-to-face interview was also conducted with relevant stakeholders involved in procurement of medicines. Blood pressure was uncontrolled in 50.4% (n = 72) of participants at UHS and 52.9% (n = 181) at KATH. With respect to medicine accessibility, 98.8% (n = 338) and 42.9% (n = 61) received at least one medication from the hospital pharmacy of KATH and UHS, respectively. Using MARS-10, 49.2% (n = 70) and 52.9% (n = 181) were nonadherent in UHS and KATH, respectively. There was a significant association between adherence and BP control at both UHS (p=0.038) and KATH (p=0.043). At UHS, there was a significant association between accessibility to medicines at the hospital and BP control (p=0.031), whilst at KATH, no significant association was observed (p=0.198). Supply chain practices and delays in payment by the NHIA affected accessibility to antihypertensive medications. Blood pressure control was inadequate among participants in both facilities. Accessibility to medicines was better at the tertiary facility compared to the secondary facility. Increased accessibility and adherence to antihypertensives were related to blood pressure control in both facilities. Good supply chain practices and prompt payment by the National Health Insurance Authority would enhance accessibility to antihypertensive medications.