Prevalence and predictors of clinic appointment non-adherence among adults with poorly controlled hypertension in a primary care setting

Abstract

Objectives: To assess the prevalence and predictors of non-adherence to clinic appointments in adult patients with poorly controlled hypertension.

Design: A descriptive cross-sectional study.

Setting: A primary care setting (family medicine clinic) overseen by family physicians in Kano, Nigeria.

Participants: Two hundred and thirty-four randomly selected patients, aged ≥ 18 years with a diagnosis of hypertension, who had been on treatment for ≥1 year and had a current blood pressure of ≥140/90 mmHg were included.

Main outcome measures: Non-adherence to clinic appointment among participants.

Results: Participants' mean age was 55±12.2 years (range: 23-85 years); they were predominantly females (163, 69.7%). Sixty (25.6%) participants were non-adherent to clinic-appointments. Being employed (OR [Odds ratio] =2.92, 95%CI [confident interval] =1.52-5.65, P=0.002), inability of participants or their children to pay the medical bills (OR=2.92,95%CI=1.42-6.00, P=0.004), and systolic blood pressure (SBP) of <160mmHg (OR=0.43, 95%CI=0.22-0.86, P=0.018) were predictors of clinic appointment non-adherence.

Conclusions: The prevalence of non-adherence to clinic appointments was high. Being employed, patients or their children's inability to pay medical bills, and higher SBP were predictors of non-adherence to clinic appointments. Therefore, more studies are needed on effective interventions to reduce non-adherence to clinic appointments in this setting.

Keywords: Hypertension; clinic appointment non-adherence; missed appointment; predictors; primary care.