Determinants of non-adherence to medications among hypertensive patients attending the Babcock university teaching hospital clinic in Ilishan-Remo, Ogun state, Nigeria

Hypertension remains a major global health issue, with over 1.28 billion adults affected worldwide. In low- and middle-income countries like Nigeria, its growing prevalence worsens the burden of non-communicable diseases and strains healthcare systems. Despite the availability of effective treatment, poor adherence to antihypertensive medication remains a significant challenge. This study explores the determinants of medication non-adherence among hypertensive patients at Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria. A descriptive cross-sectional design was employed, involving 235 hypertensive patients selected via systematic sampling. Data were collected using a pretested, structured questionnaire guided by the PRECEDE-PROCEED model, with an overall Cronbach’s alpha of 0.93. Descriptive statistics summarized the data, and Pearson correlation was used to test relationships at a 5% significance level. The findings revealed that the mean age of respondents was 53.18 ± 16.09 years, with 46.40% aged between 20 and 50 years. More than half (124; 52.80%) had a systolic blood pressure between 121 and 139 mmHg, while the majority (213; 90.60%) had a diastolic blood pressure between 81 and 89 mmHg. The mean scores were 16 ± 2.93 for predisposing factors (attitude), 10.15 ± 2.80 for reinforcing factors (social support), 9.01 ± 1.79 for enabling factors (resources), and 9.25 ± 2.50 for level of medication adherence, measured on rating scales of 24, 18, 18, and 13, respectively. Furthermore, predisposing factors (r = 0.138, p = 0.035), enabling factors (r = 0.516, p < 0.001), and reinforcing factors (r = 0.302, p < 0.001) showed a positive correlation with medication non-adherence among the respondents. Despite generally good adherence and positive attitudes, many participants faced financial barriers to medication access and lacked health insurance. Targeted policy interventions are recommended to enhance medication affordability and improve adherence outcomes.