Overview
Hypertension remains a leading modifiable risk factor for cardiovascular disease worldwide. In urban Morocco, women managing high blood pressure face unique barriers to consistent medication adherence. This cross-sectional study conducted in Inezgane’s primary health care facilities sheds light on how many women actually follow their prescribed regimens and what drives or hinders this behavior. The findings carry important implications for clinicians, policymakers, and public health programs aiming to reduce cardiovascular risk in Moroccan cities.
Prevalence of Adherence
The study reports a prevalence rate of medication adherence among women with hypertension that reflects broader regional patterns: a substantial portion struggle with consistent intake, while a smaller, but meaningful, subset demonstrates good adherence. Understanding the magnitude helps health workers prioritize interventions and allocate resources toward those most at risk of poor control and adverse outcomes.
Determinants of Adherence
Multiple interrelated factors emerged as significant determinants of whether women adhered to their antihypertensive therapy. These can be grouped into patient- and system-related domains.
Patient-Level Factors
– Knowledge and beliefs about hypertension: Women who understand the chronic nature of the disease and the role of daily medication are more likely to adhere.
– Perceived necessity versus concerns: If patients believe medications are essential and fear fewer side effects, adherence tends to increase. Conversely, worry about adverse effects or a sense that symptoms are absent can reduce consistency.
– Health literacy and education: Clear communication improves comprehension of dosing, timing, and the importance of uninterrupted therapy, especially in communities with varied education levels.
– Economic and logistical constraints: The cost of medications, transportation to clinics, and long waiting times can discourage regular refill and intake.
System-Related Factors
– Access to primary care: Regular contact with a nurse or physician during urban health visits supports adherence through counseling and monitoring.
– Medication regimen complexity: Simpler regimens with once-daily dosing tend to be associated with higher adherence compared with multiple daily doses.
– Availability and affordability of medicines: Stockouts at local facilities and out-of-pocket costs can disrupt continuity of therapy.
Implications for Practice
To improve adherence among women with hypertension in Inezgane, a multifaceted approach is recommended. Clinicians should emphasize patient education, address concerns about medications, and reinforce the long-term benefits of sustained therapy. In addition, health systems can implement supports such as reminder systems, community health worker follow-ups, and affordable medication options.
Public Health Recommendations
– Design targeted education campaigns that explain the chronicity of hypertension and the importance of consistent medication use, tailored to urban Moroccan women.
– Strengthen primary care services with routine adherence assessments, side-effect management, and simplified treatment regimens where possible.
– Improve access by ensuring reliable medication supply chains and subsidizing essential antihypertensive drugs for low-income patients.
Conclusion
Adherence to antihypertensive therapy among women in urban Inezgane is shaped by a combination of knowledge, beliefs, healthcare access, and medicine availability. By addressing these determinants through patient-centered communication and strengthened primary care, it is possible to improve blood pressure control and reduce cardiovascular risk in this population.
