Assessment of Medication Adherence and Pharmaceutical Factors in Hypertension Control Among Patients at a Tertiary Hospital in Jos, Plateau State

Hypertension is the leading non-communicable disease in Nigeria, yet blood pressure control rates remain poor across most patient populations. Medication adherence is a critical modifiable determinant of hypertension control, with pharmaceutical factors including tablet characteristics, dosing frequency, and patient counselling playing key roles. This study assessed medication adherence and pharmaceutical factors associated with blood pressure control among hypertensive patients at Jos University Teaching Hospital, Plateau State. A cross-sectional study enrolled 250 hypertensive outpatients receiving antihypertensive medications. Adherence was assessed using the validated eight-item Morisky Medication Adherence Scale. Blood pressure control was defined as sustained readings below 140/90 mmHg. Pharmaceutical factors evaluated included number of antihypertensive agents, dosing frequency, tablet size and palatability, dispensing counselling quality, and out-of-pocket medicine costs. Adherence was high in only 36% of participants. Adequate blood pressure control was achieved in 42% of patients, with significantly higher control rates among high adherers. Twice-daily dosing regimens were associated with significantly lower adherence than once-daily equivalents. High out-of-pocket medicine costs were the most frequently cited barrier to adherence. Patients who reported receiving dispensing counselling had significantly higher adherence scores. Pharmaceutical factors including simplified dosing and improved counselling practices explained 34% of the variance in adherence scores. The study recommends once-daily antihypertensive regimen preference and enhanced pharmacy counselling protocols at JUTH. Keywords: medication adherence, hypertension, Morisky scale, Jos, pharmaceutical factors.