Determinants of Non-Adherence to Hypertension Treatment Among Adults in The Lower Manya Krobo Municipality of The Eastern Region of Ghana

Abstract

Introduction: Hypertension is a widespread, life-threatening condition affecting over 1.28 billion adults globally, with a disproportionate burden in low- and middle-income countries. Despite the availability of effective medications and lifestyle interventions, treatment non-adherence remains a major barrier to blood pressure control, especially in sub-Saharan Africa. In Ghana, where the prevalence of hypertension ranges from 25% to 48%, studies show alarmingly low treatment adherence rates, often driven by a complex mix of economic, social, and cultural factors. This study aims to investigate the determinants of non-adherence with hypertension treatment among adults diagnosed with the condition in the Lower Manya Krobo Municipality of Ghana. Methodology: A cross-sectional study design was employed. Data were collected from a sample of 410 hypertensive patients attending selected health facilities within the municipality using structured questionnaires. Quantitative data were analyzed using STATA 18 to identify patterns and associations. Results were presented in tables and graphs. Results: The study revealed that non-adherence to hypertensive treatment was prevalent among respondents in the Lower Manya Krobo Municipality. Socio-economic determinants, including cost of medication, language or education barriers, and work schedules, showed significant associations with non-adherence. Psychological and behavioral factors such as the perception of being healthy without medication, fear of dependence, lack of confidence, and forgetfulness emerged as the most influential barriers. Conclusions: The findings highlight that non-adherence to hypertensive treatment is shaped less by demographic factors and more by socio-economic, psychological, and behavioral determinants. Forgetfulness and no confidence in following treatment emerged as the strongest predictors of poor adherence. These results underscore the need for targeted interventions, including patient education, reminder systems, and family or community-based support mechanisms, to improve adherence and ultimately reduce the burden of hypertension-related complications in Ghana.