Medication adherence and blood pressure control: A preliminary assessment of the role of health insurance in Nigeria and Ghana

Abstract

Objectives: This study sought to assess the current impact of health insurance coverage on medication adherence and blood pressure control of patients being managed for hypertension in Ghana and Nigeria. Methods: The study was a prospective study among 109 patients with hypertension in two health facilities with similar population dynamics in Ghana and Nigeria. Patients were systematically selected, categorized as having health insurance coverage or not, and followed up monthly for 6 months. The outcome variables (medication adherence and blood pressure control) were then measured and compared at 6 months. Analysis was done using Stata with level of significance set at p ⩽ 0.05. Results: There was a 90% insurance coverage among participants from Ghana compared to 15% from Nigeria. National Health Insurance Authority enrolees in both countries had better blood pressure control and medication adherence compared to non-enrolees (adjusted odds ratio = 2.6 and 4.5, respectively). Conclusion: National Health Insurance Authority enrolment was found to be poor among respondents in Nigeria compared to Ghana. Enrolment into the National health financing schemes in both countries led to better blood pressure control and medication adherence among patients with hypertension at primary health facilities. There is therefore the need for system strengthening to improve their sustainability.

Adherence to antihypertensive medication and its associated factors among patients with hypertension attending a tertiary hospital in Kathmandu, Nepal

“…The findings of the study are also consistent with the study done in eastern Nepal [ 17 ], which identified missed medicines due to high cost as one of the predictors of low level of adherence. It demands the strategies to reduce the high out of pocket expenditure in health such as increasing the coverage of national health insurance [ 34 ].…”

“…Different measures, like a reminder messaging alarm to reduce forgetfulness, counselling to reduce misconceptions about medications, and improving patient education, have been found to be effective improving adherence to antihypertensive medications among patients with hypertension [ 32 , 34 – 36 ]. However, the effectiveness and feasibility of those interventions in addressing the issue of non-adherence in this context should be explored in future studies.…”