Abstract
The level and predictors of medication adherence have not been given attention among populations for whom the cost of treatment is not a concern, especially in the Ghanaian healthcare setting. This study compared generalised linear models to determine the factors associated with adherence to treatment among hypertensive patients with a workplace policy that offers cost-free access in Ghana. We conducted a cross-sectional descriptive study to investigate the level of adherence and factors that influence practice among hypertensive patients with cost-free access to treatment. A total of 254 respondents were conveniently sampled and administered a questionnaire. The predictors of treatment adherence were assessed using Bivariate and generalised linear models (logistic and complementary log–log regression models). The complementary log–log regression model outperformed the logistic regression model in fitting the relationships in the data, by reporting lower AIC and BIC, and higher Nagelkerke and Cox and Snell pseudo-R-squared values. Most (88.9%) respondents scored low adherence, and only 11.1% adhered to treatment. The factors that affect adherence to hypertension medication included age (ARR = 8.58, 95%CI 1.23–83.28, p-value = 0.031), sex (ARR = 0.19, 95%CI 0.03–0.91, p-value = 0.042), location (ARR = 10.78, 95%CI 2.01–79.76, p-value = 0.007), busy schedule (ARR = 0.03, 95%CI 0.00–0.30, p-value = 0.016), time spent (ARR = 0.05, 95%CI 0.00–0.28, p-value = 0.002) and accessibility (ARR = 17.89, 95%CI 4.03–112.38, p-value < 0.001). The high level of non-adherence to treatment among patients, even when the cost of treatment is not a barrier, could contribute to overall treatment outcomes. Despite cost-free access, adherence remains low, highlighting the need for further investigation into non-cost barriers affecting treatment compliance. In addition, there is a need to design and implement measures to improve adherence among patients with hypertension in the country.
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The authors are grateful to the study participants for agreeing to be part of the study and for providing useful data that generated these findings.
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FKN conceptualised the study and supervised the data collection. FKN, KDK and DA provided ideas for the study design and discussion. DA performed the data analysis. FKN, DA, LSA, VB, JG, VD, KDK, and RQ drafted the manuscript. FKN and DA critically reviewed and approved the manuscript content.
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Ethics approval for the study was granted by the Research Ethics Committee of the University of Health and Allied Sciences (reference number: UHAS-REC A.1[50]19-20). The study was conducted following the guidelines of the institutional ethics review committee and the Declaration of Helsinki. Before participation in the study, participants signed the informed consent form. Participants granted permission for their data to be included in any publication. All the authors approved the publication of this manuscript.
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Nyande, F.K., Konlan, K.D., Asiamah, L.S. et al. The predictors of treatment adherence among hypertensive patients with cost-free access. Sci Rep (2026). https://doi.org/10.1038/s41598-026-36702-z
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DOI: https://doi.org/10.1038/s41598-026-36702-z
