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.