Published: 2021-09-27

Compliance to antihypertensive therapy and associated factors among adults’ hypertensive patients attending medical clinics in Kilifi County Kenya

John T. Moss, Harun Kimani, Isaac Mwanzo


Background: Hypertension is both public health and medical problem worldwide. Compliance to antihypertensive therapy is key in avoiding hypertension complications. The purpose of this study was to establish compliance to antihypertensive therapy and associated factors among adults’ hypertensive patients in Kilifi county Kenya.

Methods: A facility-based cross-sectional was undertaken in four public health facilities in Kilifi County Kenya. Two hundred and thirteen hypertensive patients were recruited in the study. Data was collected using a pretested questionnaire and analyzed using Statistical package for social sciences (SPSS) version 23 software. Chi-square test was utilized in establishing the relations, while logistic regression was adopted to determine independent risk factors for compliance.

Results: Compliance to antihypertensive therapy was recorded in 31 (14.6%) of the patients. A statistically significant association was established between compliance to antihypertensive therapy and patients knowledge (p<0.001); age (p=0.024); education (p=0.04); income (p=0.013); duration on treatment (p=0.005); cost (p=0.029); health care provider advice (p=0.009); consistency of therapy (p=0.002); medicines availability (p=0.021); and health facility distance (p=0.013). Independent risk factors for compliance to antihypertensive therapy were the duration on treatment of (OR=0.383; 95%CI 0.151-0.972); Knowledge on hypertension (OR=2.715; 95%CI 1.598-4.615); Health care worker follow-ups (OR=0.452; 95%CI 0.282-0.726); and cost of medication (OR=2.682; 95%CI 1.134-6.345).

Conclusions: Anti-hypertensive therapy compliance among patients was low. This could be attributed to factors that are socio-demographic, patient, and health service-related in nature. Prompt public health interventions that are patient-community centred are necessary to improve compliance to antihypertensive therapy.



Hypertension, Compliance, Antihypertensive, Therapy

Full Text:



Ministry of Health. Kenya national guidelines for cardiovascular disease management. 2018. Available at: › 2018/06 › Cardiovascular-guidelines-2018_A4_Final. Accessed on 10 May 2021.

Agbor N, Takah F, Aminde N. Prevalence and factors associated with medication adherence among patients with hypertension in sub-Saharan Africa: protocol for a systematic review and meta-analysis. BMJ Open. 2018;8(3).

Mohamed SF, Mutua MK, Wamai R. Prevalence, awareness, treatment and control of hypertension and their determinants: results from a national survey in Kenya. BMC Public Health. 2018;18:1219.

Van Kleef E,Spiering W. Hypertension is overly important but under-controlled. European Journal of Preventive Cardiology. 2017;24(3):36-43.

WHO. Geneva hypertension fact sheet. 2019. Available at: Accessed on 4 August 2020.

Cappuccio P, Miller A. Cardiovascular disease and hypertension in sub-Saharan Africa: burden, risk, and interventions. Internal and emergency medicine. 2016;11(3):299-305.

Sheppard-Law S, Zablotska-Manos I, Kermeen M, Holdaway S, Lee A, George J et al. Factors associated with non-adherence to HBV antiviral therapy. Antiviral Therapy. 2018.

Ministry of Health. Kenya Stepwise survey for Non-Communicable Diseases. 2015. Available at: › Steps-Report-NCD-2015. Accessed on 4 August 2021.

Sodovsuren N, Unurjargal T, Sanjaa N. A2030 Non-adherence to medication and risk factors of non-compliance among Mongolian people with arterial hypertension. Journal of Hypertension. 2018;36:e130.

Kazaure Z, Abubakar A, Ibrahim S, Gidado S, Sabitu K, Nguku P. Factors for nonadherence to antihypertensive drugs among Federal Civil Servants attending health facilities−Abuja, FCT.Sub-Saharan African Journal of Medicine. 2017;4(1):20.

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.

Tibebu A, Mengistu D, Bulto N. Adherence to prescribed antihypertensive medications and associated factors for hypertensive patients attending chronic follow-up units of selected public hospitals in Addis Ababa, Ethiopia. International journal of health sciences. 2017;11(4):47-52.

Rampamba M, Meyer C, Godman B, Kurdi A, Helberg E. Evaluation of antihypertensive adherence and its determinants at primary healthcare facilities in rural South Africa. Journal of comparative effectiveness research. 2018;7(7):661-72.

Mekonnen H, Gebrie H, Eyasu H, Gelagay A. Drug adherence for antihypertensive medications and its determinants among adult hypertensive patients attending in chronic clinics of referral hospitals in Northwest Ethiopia. BMC Pharmacology and Toxicology. 2017;18(1):27.

Adidja M, Valirie A, Aminde A, Ngwasiri A, Blackett N, Leopold A. Non-adherence to antihypertensive pharmacotherapy in Buea, Cameroon: A cross-sectional community-based study. BMC Cardiovascular Disorders. 2018;18(1):150.

Alefan Q, Huwari D, Alshogran OY, Jarrah MI. Factors affecting hypertensive patients' compliance with a healthy lifestyle. Patient preference and adherence. 2019;13:577-85.

Buda S, Hanfore K, Fite O, Buda S. Lifestyle modification practice and associated factors among diagnosed hypertensive patients in selected hospitals, South Ethiopia. Clinical hypertension. 2017;23(1):1-9.

Durai V, Muthuthandavan AR. Knowledge and practice on lifestyle modifications among males with hypertension. Indian Journal of Community Health. 2015;27(1):143-9.

Alefan Q, Huwari D, Alshogran OY, Jarrah MI. Factors affecting hypertensive patients' compliance with a healthy lifestyle. Patient preference and adherence. 2019;13:577-85.

Gichobi BW. Determinants of adherence to antihypertension therapy, Descriptive study in patients at Kerugoya Hospital [master’s dissertation, UON]. Research direct. 2018. Available at: Accessed on 4 August 2021.

Schulz M, Krueger K, Schuessel K. Medication adherence and persistence according to different antihypertensive drug classes: a retrospective cohort study of 255,500 patients. Int J Cardiol. 2016;220:668-76.

Pan J, Wu L, Wang H, Lei T, Hu B, Xue X et al. Determinants of hypertension treatment adherence among a Chinese population using the therapeutic adherence scale for hypertensive patients. Medicine. 2019;98(27).

Shah J, Singh V, Patil P, Gadkari R, Ramchandani V, Doshi J. Factors affecting compliance to antihypertensive treatment among adults in a tertiary care hospital in Mumbai. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2018;43(1):53.

Khayyat M, Khayyat S, Alhazmi R. Predictors of medication adherence and blood pressure control among Saudi hypertensive patients attending primary care clinics: a cross-sectional study. PloS One. 2017;12.

Nielsen J, Shrestha D, Neupane D, Kallestrup, P. Non-adherence to antihypertensive medication in low-and middle-income countries: a systematic review and meta-analysis of 92443 subjects. Journal of human hypertension. 2017;31(1):14-21.

Boima V, Ademola AD, Odusola AO, Agyekum F, Nwafor CE, Cole H et al. Factors Associated with Medication Nonadherence among Hypertensives in Ghana and Nigeria. International Journal of Hypertension. 2015.

Vedanthan R, Tuikong N, Kofler C, Blank E, Kamano JH, Naanyu V et al. Barriers and Facilitators to Nurse Management of Hypertension: A Qualitative Analysis from Western Kenya. Ethnicity & disease. 2016;26(3):315-22.

Akoko BM, Fon PN, Ngu RC, Ngu KB. Knowlegde of Hypertension and compliance with therapy among Hypertensive patients in the Bamenda Health District of Cameroon.Across-sectional Study. Cardiol Ther. 2017;6:53-67.

Getenet A, Tesfa M, Ferede A, Molla Y. Determinants of adherence to antihypertensive medications among adult hypertensive patients on follow-up in Hawassa Referral Hospital: A case-control study. JRSM Cardiovascular Disease. 2019;8.

Teshome, DF, Bekele, KB, Habitu YA. Medication adherence and its associated factors among hypertensive patients attending the Debre Tabor General Hospital, northwest Ethiopia. Integra Blood Pressure Control. 2017;10:1.

Yue Z, Bin W, Weilin Q, Aifang Y. Effect of medication adherence on blood pressure control and risk factors for antihypertensive medication adherence. Journal of evaluation in clinical practice. 2015;21(1):166-72.

Rahmathulla V, Srinivasan A, Kannan S, Shareef A. Impact of hospital pharmacist education on adherence, knowledge, attitude, and practice of hypertensive patients in a private multispecialty hospital. Int J Pharm Sci Rev Res. 2014;3(10):14-25.