Patterns of Drug Use and Adherence in the Management of Hypertension in a Health Care Facility in Warri, Delta State, Nigeria

Abstract

Hypertension is one of the treatable causes of cardiovascular morbidity and mortality. Management and evaluation of hypertension helps to streamline treatment protocols in hospitals that conform to global practice standards. Critical to hypertension management is adherence and lack of knowledge to adhering to prescribed medications may constitute treatment failure. To determine the patterns and adherence level of antihypertensives and impacting factors to non-adherence.The case files of adult hypertensive patients of the Central hospital Warri that were surveyed for a period of six months was 400 for drug use pattern. Reasons for non-adherence was also gathered. The 8-item Morisky questionnaire was used to gather information on adherence. Females affected was 69.8% with mean systolic blood pressure (SBP) of 153.3mmHg±16.7 and males 30.2% with mean systolic blood pressure (SBP) of 155.3mmHg±17.3% and mean diastolic blood pressure (DBP) for females (91.8mmHg±10.7) and males (92.0mmHg±9.8). After the start of therapy, mean SBP and DBP for females (143.8mmHg±22.3; 86.4mmHg±12.5) and males (143.6mmHg±22.1; 87.9mmHg±11.6). The most frequently prescribed antihypertensive was calcium channel blockers (29.7%) and next was angiotensin converting enzyme inhibitors (24.8%) and these were the commonest multitherapy (50%) encountered. Adherence level was 84%. Reasons for non-adherence were affordability and forgetfulness to take medications. Calcium-channel blockers and angiotensin converting enzyme inhibitors were mostly prescribed, and as dual therapy while diuretics were rarely used. Adherence to medication was relatively high, but their blood pressure was poorly controlled. Reasons for non-adherence were the inability of respondents to afford medications and forgetfulness.