Cross-Sectional Survey of Written Medicine Information Use, Health Literacy and Adherence among Hypertensive Patients in Southwest Nigeria

Introduction: Hypertension is the leading risk factor for cardiovascular and kidney disease in Nigeria and significantly contributes to morbidity and mortality. In spite of available, safe and efficacious medicines, diagnosis, initiation of treatment, and treatment outcomes are still suboptimal in Nigeria. Only 29% are diagnosed, 12% are being treated and 2.8% at treatment goals. This study aimed to investigate how hypertensive patients in Southwest Nigeria use written medicine information (WMIs) and their impact on adherence to medicine use. Methods: This was a cross-sectional survey among hypertensive patients living in Southwest Nigeria. The survey tool used was pre-validated (Cronbach alpha 0.774); it elicits demographic information and research questions on behaviour, experience, knowledge of medicine for hypertension and adherence. The population was systematically sampled (every X+1th patient) for qualified respondents. The data were summarised using descriptive statistics and analysed with a chi-square test for categorical outcomes. Microsoft Excel and SPSS v29 were used for the analysis of the data. The study was approved and given oversight by the Health and Research Ethics Committee of the Lagos University Teaching Hospital, Idi-Araba. Results: Most of the respondents (72.6%) in the study reported having seen a WMI in the past three months, with a majority (61.7%) reporting that they opened it up to read it. Fewer respondents however identified that they always opened the WMI to read if they were getting the medicine for the first time (6.1%), had got it more than once (8.9%) or the WMI had been used in the counselling session (15.4%). Most of the respondents reported having a positive experience with WMIs. The relationship between patient's adherence score to age, their preferred information source, behaviours and impact (except for impact of WMIs on information seeking behaviour) was statistically significant (p< 0.05). Conclusion: This study shows that across the four states, patient experience with WMIs was largely positive, though moderated by poor health literacy and inadequate adherence to medicines.