Non-adherence to antihypertensive drugs and its risk factors among hypertensive patients, Marrakech, Morocco

Abstract

Non-adherence to hypertensive drugs is a barrier to controlling blood pressure and decreases hypertensive patients’ quality of life. The aim of this study was to determine the prevalence of non-adherence to hypertensive drugs among hypertensive patients treated at Marrakech’s primary health care facilities. A cross-sectional survey of 922 hypertensive patients treated at Marrakech’s primary health care facilities for arterial hypertension was conducted between 2021 and 2022. For collecting data, two questionnaires were employed. One was administered during an interview to patients and focused on socio-demographic, behavioral, and clinical variables, as well as hypertensive treatment characteristics and the care-patient-physician triad. The physician self-administered the second questionnaire to assess therapeutic inertia. Non-adherence risk factors were identified using multivariate logistic regression. A total of 760 participants did not adhere to the hypertensive drugs, with a prevalence of 82.4%. The average age was 62.8±9.8 years, and 600 (78.9%) of the participants were female. Moderate stress, unsatisfactory family support, uncontrolled hypertension, the presence of depressive symptoms, an insufficient patient-physician interaction, and inadequate medical management of cardiovascular risk factors were associated with drug non-adherence. Non-adherence to hypertensive treatment is common in Marrakech. Regular therapeutic education classes and support group meetings must be scheduled. A performance-based remuneration system to incentivize health-care workers should be investigated.