Medication Adherence and Perceived Family Support Among Elderly Patients with Hypertension Attending a Specialty Clinic in Lagos, Nigeria
DOI:
https://doi.org/10.30442/ahr.0901-04-188Abstract
Background: Hypertension and medication adherence are global public health challenges, with elderly patients suffering the most because they frequently have multiple co-morbidities.
Objective: To evaluate the level of medication adherence and perceived family support among Nigerian elderly patients with hypertension.
Methods: A descriptive, cross-sectional study among 293 consecutively consenting elderly hypertensive patients using an interviewer-administered, semi-structured questionnaire. The Modified Morisky Adherence Scale (MMAS-8) and Perceived Social Support-Family Scale (PSS-Fa) tools were used to assess medication adherence and perceived family support, respectively.
Results: The mean age of respondents was 69.5±6.4 years. Medication adherence was good, moderate and poor among 14.3%, 68.6%, and 17.1% of the respondents respectively. Difficulty remembering to take medications was the primary reason for non-adherence in 73.7% of cases. Good adherence to medication was significantly associated with male gender (p = 0.046), living with grandchildren (p˂0.001), having other sources of income (p = 0.026) and receiving treatment for comorbid illnesses (p = 0.025). A higher proportion of the respondents (94.9%) had strong perceived family support, which lacked statistical significance regarding good medication adherence. (p = 0.739).
Conclusion: This study found medication adherence low, despite most participants' strong family support. Forgetfulness and financial constraints were the primary reasons for poor medication adherence. Although family support is highly recommended and beneficial for medication adherence, other comorbid and social factors should be considered.
References
De Terline DM, Kane A, Kramoh KE, Toure IA, Mipinda JB, Diop IB, et al. Factors Associated with Poor Adherence to Medication among Hypertensive Patients in Twelve Low and Middle-Income Sub-Saharan Countries. PLoS One 2019;14. https://doi.org/10.1371/journal.pone.0219266
WHO. Adherence to Long-Term Therapies: Evidence for Action.2015; [Accessed 01 March 2021]. Available from http://apps.who.int/iris/bitstream/handle/10665/42682/9241545992.pdf.
Asgedom SW, Atey TM, Desse TA. Antihypertensive Medication Adherence and Associated Factors among Adult Hypertensive Patients at Jimma University Specialized Hospital, Southwest Ethiopia. BMC Res Notes 2018;11:27. https://doi.org/10.1186/s13104-018-3139-6.
Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M. Hypertension in the Elderly. World J Cardiol 2012;4:135-47. https://doi.org/10.4330/wjc.v4.i5.135.
Uchmanowicz B, Chudiak A, Uchmanowicz I, Rosińczuk J, Froelicher ES. Factors influencing Adherence to Treatment in Older adults with hypertension. Clin Interv Aging 2018;13:2425–2441. https://doi.org/10.2147/CIA.S182881
United Nations. World Population Aging 2019 [Accessed 24-03-2021]. Available from: http://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2013.pdf.
WHO. Health statistics and health information systems, definition of an Older or Elderly person Proposed Working Definition of an Older Person in Africa. The World Health Organisation 2001 [cited 08 March 2021]. Available from: http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html
WHO. Ten facts on ageing and health. WHO. World Health Organization; 2017. [cited 02 March 2021]. Available from: https://www.who.int/news-room/fact-sheets/detail/10-facts-on-ageing-and-health
Padhy M, Lalnuntluangi R, Chelli K, Padiri RA. Social Support and Adherence among Hypertensive Patients. AJHM 2016:1:33-40.
Iloh G. Family Functionality, Medication Adherence and Blood Glucose Control in Ambulatory Type 2 Diabetic Patients in a Nigerian Hospital. Basic Clin Pharm 2017;8:149-153.
Kristianingrum ND, Wiarsih W, Nursasi AY. Perceived Family Support among Older persons in Diabetes mellitus Self-management. BMC Geriatr 2018;18:304. https://doi.org/10.1186/s12877-018-0981-2
Boima V, Ademola AD, Odusola AO, Agyekum F, Nwafor CE, Cole H, et al. Factors Associated with Medication Non-adherence among Hypertensives in Ghana and Nigeria. Int J Hypertens 2015;2015:205716. https://doi.org/10.1155/2015/205716.
Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a Medication Adherence Measure in an Outpatient Setting. J Clin Hypertens 2008;10:348-354. https://doi.org/10.1111/j.1751-7176.2008.07572.x.
Morisky DE, Green LW, Levine DM. Concurrent and Predictive validity of a self-reported measure of Medication Adherence. Med Care 1986;24:1-24. https://doi.org/10.1097/00005650-198601000-00007
Ezeala-Adikaibe B. Factors Associated with Medication Adherence among Hypertensive Patients in a Tertiary Health Center: A Cross-Sectional Study. Arch Community Med Public Health 2017;3:024–031. https://doi.org/10.17352/2455-5479.000021
Sheilini M, Hande HM, George A. Family Support and Medication Non-adherence among Elderly on Antihypertensives. Indian J Public Health Res Dev 2019;10:294–298. https://doi.org/10.5958/0976-5506.2019.00706.X
Ajayi DT, Adedokun BO, Owoeye DO, Akpa OM. Treatment Satisfaction and Medication Adherence Among Hypertensive Patients Seeking Care in Selected Hospitals in Ibadan, Nigeria. Arch Basic Appl Med.2018;6:67–72.
Procidano M. Measures of Perceived Social Support from Friends and from Family: Three Validation Studies. Artic Am J Community Psychol.1983;11:1-24. https://doi.org/10.1007/BF00898416
Nigeria releases new report on poverty and inequality in the country [Internet]. [cited 08 August 2021]. Available from:: https://www.worldbank.org/en/programs/lsms/brief/nigeria-releases-new-report-on-poverty-and-inequality-in-country
Ayonote, U A, Akujuobi, O M, Ogbonna, A N. Family Social Support Perceptions and Medication Adherence among Elderly Diabetics in a Tertiary Health Institution in Lagos, Nigeria. Curr Res Diabetes Obes J 2022;16:555927. https://doi.org/10.19080/CRDOJ.2022.16.555927
Adebusoye LA, Ladipo MM, Owoaje ET, Ogunbode AM. Morbidity Pattern amongst Elderly Patients presenting at a Primary Care Clinic in Nigeria. Afr J Prim Health Care Fam Med 2011;3. https://doi.org/10.4102/phcfm.v3i1.211
Akinola FT. Relationship Between Family Support, Psychological Well-being and Blood Pressure Control among Patients with Hypertension Attending Geriatric Care Centre. A dissertation submitted to the National Postgraduate Medical College Of Nigeria, Fellowship in Family Medicine (May 2016). https://dissertation.npmcn.edu.ng/index.php/FMCFM/article/download/243/1818
Lam K, Lu AD, Shi Y, Covinski KE. Assessing Telemedicine Unreadiness among Older Adults in the United States during the COVID-19 Pandemic. JAMA Intern Med 2020;180:1389-1391. https://doi.org/10.1001/jamainternmed.2020.2671.
Oluwole EO, Osibogun O, Adegoke O, Adejimi AA, Adewole AM, Osibogun A. Medication Adherence and Patient Satisfaction among Hypertensive Patients Attending Outpatient Clinic in Lagos University Teaching Hospital, Nigeria. Niger Postgrad Med J 2019;26:129–137. https://doi.org/10.4103/npmj.npmj_48_19
Adeoye AM, Adebiyi AO, Adebayo OM, Owolabi MO. Medication Adherence and 24hr Blood Pressure in Apparently Uncontrolled Hypertensive Patients. Niger Postgrad Med J 2019;26:18–24. https://doi.org/10.4103/npmj.npmj_147_18
Adisa R, Ilesanmi OA, Fakeye TO. Treatment Adherence and Blood pressure Outcome among Hypertensive outpatients in two Tertiary Hospitals in Sokoto, Northwestern Nigeria. BMC Cardiovasc Disord 2018;18:194. https://doi.org/10.1186/s12872-018-0934-x
Ojo O, Malomo S, Sogunle P. Blood pressure (BP) control and Perceived Family support in patients with Essential hypertension seen at a Primary Care Clinic in Western Nigeria. J Family Med Prim Care 2016;5:569. https://doi.org/10.4103/2249-4863.197284
Ilori HT, Adebusoye LA, Daramola OO, Ajetunmobi OA. Perceived Family Support and its effect on Cardiovascular Disease Risk among Hypertensive Patients presenting at a Family Medicine Practice in South West Nigeria. Niger J Family Pract 2021;11:19–26.
Olalemi OE, Muyibi SA, Ladipo MM. Perceived Family Support and Medication Adherence amongst Hypertensive Outpatients in a Tertiary Hospital, Ibadan, Nigeria. West Afr J Med 2020;37:481–489.
Khayyat SM, Khayyat SMS, Hyat Alhazmi RS, Mohamed MMA, Hadi MA. Predictors of Medication Adherence and Blood pressure Control among Saudi Hypertensive Patients Attending Primary Care Clinics: A Cross-sectional Study. PLoS One 2017;12:1–12. https://doi.org/10.1371/journal.pone.0171255.
Arukala P. Impact of Co-morbidities on Medication Adherence in Hypertensive Patients. Value Health 2016;19:A615. https://doi.org/10.1016/i.iva1.2016.09.1546.
Burnier M, Polychronopoulou E, Wuerzner G. Hypertension and Drug Adherence in the Elderly. Front Cardiovasc Med 2020;7:49. https://doi.org/10.3389/fcvm.2020.00049.
Bakare O, Akinyinka M, Goodman O, Kuyinu Y, Wright O, Adeniran A, et al. Antihypertensive use, Prescription Patterns, and Cost of Medications in a Teaching Hospital in Lagos, Nigeria. Niger J Clin Pract 2016;19:668. https://doi.org/10.4103/1119-3077.188709.
Shangzi X, Nicholas P, Truls S, Micigerhael O, Xuefeng Z, Caroline W, et al. Family Support and Medication Adherence among Residents with Hypertension in Informal Settlements of Nairobi, Kenya: a Mixed-method Study J Hum Hypertens 2023;37:74-79. https://doi.org/10.1038/s41371-022-00656-2.
Ayodapo AO, Monsudi KF, Omosanya OE, Elegbede OT. Family Functioning and Adherence to Medication: A Study of Hypertensive in a Tertiary Hospital, South Western Nigeria. Christmed J Health Res 2018;5:197. https://doi.org/10.4103/cjhr.cjhr_28_18
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Annals of Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.
