Prevalence and determinants of medication adherence among patients taking antihypertensive medications in Africa: A systematic review and meta-analysis 2010-2021.
Jinhee Shin, Kennedy Diema Konlan
PMID 36693022WHAT IT FOUND
Across African hypertension patients, pooled medication adherence was 58.0%, but study estimates ranged from 8.9% to 96.8%.
Forgetfulness, cost, multiple doses, side effects and low knowledge were key barriers.
Key findings
01The pooled prevalence of medication adherence among African hypertension patients was 58.0%, but study estimates ranged from 8.9% to 96.8%.
02The determinants were grouped into hypertension control, knowledge about medications, drug-related factors, and sociocultural and financial factors.
03Patients counselled by a nurse were more likely to be adherent than those not counselled by a nurse.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All included studies were cross-sectional questionnaire studies, so they cannot show that any factor causes adherence. Adherence was measured with different tools, and the pooled prevalence had very high heterogeneity, so the 58.0% estimate should not be treated as one stable Africa-wide rate. Self-reported adherence may have recall bias, and recall and selection bias can overestimate adherence. No included study tested a medication adherence intervention in Africa, so the review cannot show which strategy works. Cognitive function was not assessed, although it could affect forgetfulness or deliberate decisions about medication.
Declared interests
The authors report no funding and no conflict of interest.
The easy way to misread this
Do not conclude that nurse counselling improves medication adherence. The review found only an association from a cross-sectional study, and no intervention study tested counselling.