Overview
Hypertension remains a major modifiable risk factor for cardiovascular disease globally. In Morocco, urban primary health care facilities in towns like Inezgane are pivotal in managing chronic conditions such as hypertension. This article summarizes findings from a cross‑sectional study that assessed how prevalent medication adherence is among women with hypertension and identified the determinants that influence whether these women take their medicines as prescribed.
Prevalence of Medication Adherence
The study evaluated adult women diagnosed with hypertension who attended urban primary health care facilities in Inezgane. Using standardized adherence measures, researchers quantified the proportion of participants who followed their prescribed treatment regimens. Results indicated a spectrum of adherence, with a substantial subset reporting high adherence while a meaningful minority exhibited partial or poor adherence. The observed prevalence mirrors trends in similar urban populations where access to care exists but barriers—economic, educational, and psychosocial—shape daily medication routines.
Key Determinants of Adherence
Adherence to antihypertensive therapy is multifactorial. The study identified several determinants that consistently correlated with higher or lower adherence among women in this setting:
- Age and menopausal status: Older women and those experiencing hormonal transitions reported different adherence patterns, potentially linked to comorbidity burden and perceived health risk.
- Educational attainment and health literacy: Higher education levels and better understanding of hypertension were associated with improved adherence, underscoring the role of patient education.
- Socioeconomic factors: Economic constraints and affordability of medications emerged as barriers to sustained adherence, even in urban clinics with subsidized care.
- Medication burden and regimen complexity: A greater number of daily medicines or complex dosing schedules reduced adherence probability due to forgetfulness or inconvenience.
- Perceived treatment benefits and side effects: Beliefs about medication effectiveness and concerns about adverse effects influenced persistence with therapy.
- Healthcare system and provider communication: Regular follow-up, trust in clinicians, and clear communication about treatment goals helped women stay adherent.
- Social support: Support from family, friends, or community groups facilitated routine medication taking and attendance at follow‑ups.
Implications for Public Health and Practice
The findings highlight actionable areas for improving adherence among women with hypertension in urban Morocco. Targeted interventions could include:
- Educational programs tailored to varying literacy levels, emphasizing the importance of consistent antihypertensive medication even when symptoms are not apparent.
- Medication reconciliation and simplification where possible to reduce regimen complexity.
- Subsidized or affordable medication access through public primary care facilities, pharmacies, or community-based programs.
- Strengthened patient–provider communication with shared decision making and regular adherence monitoring.
- Community support initiatives, including peer groups and reminder systems (SMS, phone calls, or calendar prompts).
Limitations and Future Directions
As a cross‑sectional study conducted in selected urban clinics, the results may not generalize to rural areas or other regions of Morocco. Longitudinal research is needed to assess causality and examine how adherence evolves with changes in policy, medication availability, and health literacy programs.
Conclusion
Adherence to antihypertensive medications among women in Inezgane is influenced by a constellation of individual, social, and health system factors. By addressing education, affordability, regimen burden, and provider communication, primary health care services can improve adherence and, in turn, reduce the cardiovascular risk burden for Moroccan women.
