Drug Non-adherence in Hypertensive Patients in Morocco, and Its Associated Risk Factors

Aims: Hypertension is a widespread public health problem; unfortunately, non-adherence to the treatment hinders the control of high blood pressure. Drug non-adherence is the degree to which a patient does not follow the prescription. We aimed to assess the extent of drug non-adherence among hypertensive patients treated in Meknes and identify risk factors associated with inobservance.

Methods And Results: Between November and December 2017, we conducted a cross-sectional study enrolling 922 hypertensive patients managed at Meknes's primary healthcare facilities (PHCF) using the multistage sampling method. We interviewed patients face to face to collect their socio-demographic characteristics, lifestyle behaviours, clinical parameters, and the relationship between the care system, the patient, and the physician. A multivariate logistic regression analysis highlighted the risk factors associated with drug non-adherence. The prevalence of drug non-adherence was 91% with a mean age of 61 ± 11 years (mean ± standard deviation) and a male/female ratio of 1/3. Risk factors associated with drug non-adherence were: (i) male sex [adjusted odds ratio (AOR) = 2.5, 95% confidence interval (CI) (1.26-5.10)]; (ii) monthly income per household <150$ [AOR = 4.47, 95% CI (1.22-16.34)]; (iii) monthly income per household 150-200$ [AOR = 4.44, 95% CI (1.04-18.93)]; (iv) bad relationship with the healthcare system [AOR = 2.17, 95% CI (1.29-3.67)]; and (v) uncontrolled blood pressure [AOR = 1.87, 95% CI (1.15-3.02)].

Conclusion: The prevalence of drug non-adherence is general among hypertensive patients in Meknes. Prevention should: (i) ensure the availability of adequate stocks of the anti-hypertensive drug at the PHCF; (ii) secure sufficient drug stocks to treat the poorest patients first; and (iii) improve blood pressure control in patients.