Determinants of hypertension medication adherence among older adults in a resource-limited peri-urban setting, Ghana.

BACKGROUND: Hypertension is a leading cause of morbidity and mortality among older adults, with effective management heavily reliant on consistent medication adherence. AIM: This study aimed to evaluate the knowledge, prevalence, and associated factors influencing medication adherence among older adult hypertensive patients in Sokode, Ho. METHODS: A community-based cross-sectional study was conducted among 202 older adults (≥60 years) with hypertension in Sokode. A structured questionnaire was used to collect data on sociodemographic, medical history, knowledge of hypertension and medication, adherence behaviors, and barriers to adherence. Knowledge was assessed using a Likert scale and categorized as poor, satisfactory, or excellent. Medication adherence was measured using six behavioral items and classified as good or poor. Data were analyzed using R version 4.5.1, with descriptive statistics and chi-square tests applied. RESULTS: The majority of participants (80.2%) had good knowledge of hypertension and its management. However, medication adherence was poor: 60.9% demonstrated poor adherence. Common reasons for non-adherence included forgetfulness (46%), stopping medication when feeling better (46.5%), and cultural/religious beliefs (50.5%). Factors significantly associated with higher adherence included monthly income, age (above 79 years), and years since diagnosis (more than 10 years). Patients earning between 1000.00 and 2000.00 (aOR = 0.57, 95%CI: 0.41-0.81, p-value = 0.002) and those earning above 2000.00 (aOR = 0.87, 95%CI: 0.41-0.90, p-value = 0.002) had lower odds of adherence compared to those earning less than 1000.00. Also, older adults aged above 79 years (aOR = 2.3, 95%CI: 0.38-0.98, p-value = 0.050) and those diagnosed more than 10 years (aOR = 3.11, 95%CI: 1.29-1.62, p-value = 0.045) had higher odds of medication adherence. CONCLUSION: Despite adequate knowledge about hypertension, medication adherence among older adult patients in Sokode remains critically low. Interventions should move beyond general education to include practical support such as medication reminders, simplified regimens, culturally sensitive counseling, and continuous follow-up to improve adherence and health outcomes in this population.