Factors associated with medication adherence among hypertensive patients in Namibia

Abstract

Background: Hypertension is a major public health concern, with non-adherence to treatment undermining disease management and control. In Namibia, little research exists on medication adherence among hypertensive patients, particularly in the Kavango East region, Namibia. Aim: This study examined demographic, clinical, behavioural, and health system factors associated with medication adherence among hypertensive patients at a regional hospital in the Kavango East region, Namibia. Setting: The study was conducted at the outpatient department of a regional hospital in north-eastern Namibia. Methods: A quantitative, cross-sectional approach was used with 200 hypertensive patients selected through consecutive sampling. Data were collected by using a self-administered questionnaire and analysed with Chi-squared tests and logistic regression to assess associations with adherence. Results: Non-adherence to antihypertensive medications was common, with 62% (n = 124) reporting missed doses. Key reasons included forgetfulness (n = 112; 56%), side effects (n = 88; 44%), financial constraints (n = 74; 37%), transport barriers (n = 64; 32%), and poor knowledge (n = 52; 26%). Significant predictors of poor adherence included forgetfulness (adjusted odds ratio [AOR] = 0.39, p = 0.006), side effects (AOR = 0.42, p = 0.011), financial constraints (AOR = 0.40, p = 0.009), and transport difficulties (AOR = 0.44, p = 0.019). Employment (AOR = 0.52, p = 0.041) and living with hypertension for ≥ 5 years (AOR = 1.75, p = 0.047) were protective, while men were 1.48 times more likely to adhere than women. Conclusion: Adherence to antihypertensive therapy is undermined by socioeconomic, behavioural, and health system barriers. Contribution: This study provides much-needed evidence on the determinants of medication adherence in Namibia. It offers guidance for public health strategies, community awareness, and improved hypertension management outcomes.