Relationship between patient satisfaction with medical care and medication non-adherence among hypertensive patients attending a general Outpatient Department in southwest Nigeria

Abstract

Background: Medication non-adherence (MNA) is prevalent in hypertension. Patient satisfaction is derived from the patient's appraisal of how well the provider meets his or her personal emotional and physical needs. The objectives of this study were to determine the factors associated with medication non-adherence; and to also ascertain the relationship between patient satisfaction with medical care and medication non-adherence among hypertensive patients.
Methods: Cross sectional study which was conducted in the Family Medicine clinic of the Federal Teaching Hospital, Ido-Ekiti. The sample size was 337. Morisky Medication Adherence Scale (MMAS-8), and the Patient Satisfaction Questionnaire (PSQ-18) were the questionnaires used. Data was analysed using the Statistical Package for Social Sciences (SPSS).
Results: The majority {185 (54.9%)} of the hypertensives were in the age-group 45 – 64 years. The male to female ratio was 1:0.67. The largest proportion of the respondents {134 (39.8%)} had low adherence (medication non-adherence), while 104 (30.9%) and 99 (29.3%) had medium and high medication adherence level respectively. Mean satisfaction scores of 3 and above were obtained in the Technical Quality (3.54 ± 0.81),  Accessibility and Convenience (3.48 ± 0.87), Communication (3.23 ± 0.95) and Interpersonal Manner (3.09 ± 0.98) subscales. The subscales with mean satisfaction scores of less than 3 were the General Satisfaction (2.82 ± 1.23), Financial Aspects (1.91 ± 0.82), and Time Spent with Doctor (1.85 ± 0.82) which had the least score. There were statistically significant strong positive correlations between medication adherence and each of the seven patient satisfaction subscales. The significant predictors of medication non-adherence were having primary education or no formal education,  having monthly income of less than ₦50,000, and being overweight or obese.
Conclusion: Physicians should deliver quality care in a way to achieve high ratings of patient satisfaction. This will influence patients to adhere better to their antihypertensive medications.

Keywords: Patient satisfaction, medication non-adherence, blood pressure, hypertension, Nigeria