Prevalence and factors behind non-adherence to treatment among patients with hypertension in Baghdad teaching hospital

Background: Hypertension is one of the most prevalent non-communicable diseases both globally and in Iraq. It significantly contributes to the risk of cardiovascular events and other complications. A major contributing factor to poor blood pressure control is non-adherence to antihypertensive therapy. Aim: This study aimed to assess the prevalence of non-adherence among hypertensive patients, explore its relationship with socio-demographic characteristics, and identify the most frequently reported reasons for non-adherence. Methods: A cross-sectional study was conducted over five months, from February 1st to the end of July 2024, at Medical City Hospital in Baghdad. A total of 399 hypertensive patients were recruited using a convenient sampling method. Data collection involved a structured questionnaire for socio-demographic information and the Morisky 8-item Medication Adherence Scale to assess adherence levels. Results: The findings revealed that non-adherence was highly prevalent, with 87.7% of patients categorized as low adherent, 9.5% as moderate, and only 2.8% as highly adherent. Statistically significant associations were found between adherence level and variables such as age, marital status, educational level, duration of disease, number of medications for comorbidities, and frequency of medication intake. Commonly reported reasons for non-adherence included forgetfulness, high medication costs, and the misconception that treatment is only necessary when symptoms are present. Conclusion: This study highlights an alarmingly high rate of non-adherence among hypertensive patients in Iraq. Urgent interventions are required to promote adherence and improve outcomes.