Non-adherence to antihypertensive pharmacotherapy in Buea, Cameroon: a cross-sectional community-based study

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Adidja, Nkengla Menka
Agbor, Valirie Ndip
Aminde, Jeannine A
Ngwasiri, Calypse A
Ngu, Kathleen Blackett
Aminde, Leopold Ndemnge
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BACKGROUND: Hypertension is a challenging public health problem with a huge burden in the developing countries. Non-adherence to antihypertensive treatment is a big obstacle in blood pressure (BP) control and favours disease progression to complications. Our objectives were to determine the rate of non-adherence to antihypertensive pharmacotherapy, investigate factors associated with non-adherence, and to assess the association between non-adherence and BP control in the Buea Health District (BHD), Cameroon. METHODS: A community-based cross-sectional study using stratified cluster sampling was conducted in the BHD from November 2013 - March 2014. Eligible consenting adult participants had their BP measured and classified using the Joint National Committee VII criteria. The Morisky medication adherence scale was used to assess adherence to BP lowering medication. Multivariable logistic regression models were used to predict non-adherence. RESULTS: One hundred and eighty-three participants were recruited with mean age of 55.9 years. Overall, 67.7% (95% CI: 59.8-73.6%) of participants were non-adherent to their medications. After adjusting for age, sex and other covariates, forgetfulness (aOR = 7.9, 95%CI: 3.0-20.8), multiple daily doses (aOR = 2.5, 95%CI: 1.2-5.6), financial constraints (aOR = 2.8, 95%CI: 1.1-6.9) and adverse drug effects (aOR = 7.6, 95%CI: 1.7-33.0) independently predicted non-adherence to anti-hypertensive medication. BP was controlled in only 21.3% of participants and was better in those who were adherent to medication (47.5% versus 8.2%, p <  0.01). CONCLUSION: At least two of every three hypertensive patients in the Buea Health District are non-adherent to treatment. Forgetfulness, multiple daily doses of medication, financial constraints and medication adverse effects are the major predictors of non-adherence in hypertensive patients. These factors should be targeted to improve adherence and BP control, which will contribute to stem hypertension-related morbidity and mortality.

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BMC Cardiovascular Disorders

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© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Adidja, NM; Agbor, VN; Aminde, JA; Ngwasiri, CA; Ngu, KB; Aminde, LN, Non-adherence to antihypertensive pharmacotherapy in Buea, Cameroon: a cross-sectional community-based study, BMC Cardiovascular Disorders, 2018, 18 (1), pp. 150:1-150:9