The Predictive Effect of Pharmacotherapy-Related Factors on Uncontrolled Hypertension among Hypertensive Patients on Treatment in the Sekyere East District, Ghana: A Facility-Based Analytical Cross-Sectional Survey

The Predictive Effect of Pharmacotherapy-Related Factors on Uncontrolled Hypertension among Hypertensive Patients on Treatment in the Sekyere East District, Ghana: A Facility-Based Analytical Cross-Sectional Survey | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Predictive Effect of Pharmacotherapy-Related Factors on Uncontrolled Hypertension among Hypertensive Patients on Treatment in the Sekyere East District, Ghana: A Facility-Based Analytical Cross-Sectional Survey BERNARD GYAMFI ANANE, Philemon Adoliwine Amooba, Edward Appiah Boateng, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9354071/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Clinical guidelines recommend pharmacotherapy as the primary intervention for hypertension control once blood pressure exceeds treatment thresholds. However, many patients on treatment still present with uncontrolled hypertension, which remains a major cause of adult hospitalisations and cardiovascular complications in Ghana. This study, therefore, assessed the predictive effect of pharmacotherapy-related factors on uncontrolled hypertension among patients receiving treatment at the Effiduase District Hospital in Ghana. Methods An analytical cross-sectional study was conducted at the Effiduase District Hospital. Stratified random sampling was employed to sample 453 hypertensive patients on treatment. Data were collected using a questionnaire and a medical records review. Two nested logistic regression models were applied to identify the predictive effect of pharmacotherapy on uncontrolled hypertension. Pharmacotherapy-related variables that remained statistically significant in the fully adjusted model (p < 0.05), along with adjusted odds ratios and corresponding 95% confidence intervals, were considered independent predictors of uncontrolled hypertension. Results The magnitude of uncontrolled hypertension was 33% (n=154). In the fully adjusted model, medication non-adherence [AOR=2.06, 95% CI:1.29-3.29 ] , polytherapy [AOR=19.00, 95% CI:4.38-82.43] and guideline discordant prescription [AOR=3.40, 95% CI: 1.29-8.91] were independently associated with increased odds of uncontrolled hypertension Medication financing was associated with uncontrolled hypertension in the unadjusted [COR=1.92, 95% CI: 1.04-3.53] and the partially adjusted models [AOR=2.00, 95% CI: 1.03-3.90], the association lost its significance [AOR=1.89, 95% CI: 0.92-3.87] in the fully adjusted model. Conclusion Pharmacotherapy remains essential in controlling hypertension. Non-adherence to antihypertensive medications, guideline discordant therapy, and polypharmacy independently increase patients’ risk of uncontrolled hypertension. This highlights the importance of patient-level self-management behaviours regarding medications and the need for prescribers to follow evidence-based treatment guidelines to achieve optimal hypertension control. Guideline discordant therapy Medication adherence Pharmacotherapy Predictive effect Uncontrolled hypertension Full Text Additional Declarations No competing interests reported. Supplementary Files HHAGuideline.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9354071","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":619485035,"identity":"148d77d5-7569-4cac-b1fc-6bb383a543fd","order_by":0,"name":"BERNARD GYAMFI 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adherence, Pharmacotherapy, Predictive effect, Uncontrolled hypertension","lastPublishedDoi":"10.21203/rs.3.rs-9354071/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9354071/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClinical guidelines recommend pharmacotherapy as the primary intervention for hypertension control once blood pressure exceeds treatment thresholds. However, many patients on treatment still present with uncontrolled hypertension, which remains a major cause of adult hospitalisations and cardiovascular complications in Ghana. This study, therefore, assessed the predictive effect of pharmacotherapy-related factors on uncontrolled hypertension among patients receiving treatment at the Effiduase District Hospital in Ghana.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn analytical cross-sectional study was conducted at the Effiduase District Hospital. Stratified random sampling was employed to sample 453 hypertensive patients on treatment. Data were collected using a questionnaire and a medical records review. Two nested logistic regression models were applied to identify the predictive effect of pharmacotherapy on uncontrolled hypertension. Pharmacotherapy-related variables that remained statistically significant in the fully adjusted model (p \u0026lt; 0.05), along with adjusted odds ratios and corresponding 95% confidence intervals, were considered independent predictors of uncontrolled hypertension.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe magnitude of uncontrolled hypertension was 33% (n=154). In the fully adjusted model, medication non-adherence [AOR=2.06, 95% CI:1.29-3.29\u003cstrong\u003e]\u003c/strong\u003e, polytherapy [AOR=19.00, 95% CI:4.38-82.43] and guideline discordant prescription [AOR=3.40, 95% CI: 1.29-8.91] were independently associated with increased odds of uncontrolled hypertension Medication financing was associated with uncontrolled hypertension in the unadjusted [COR=1.92, 95% CI: 1.04-3.53] and the partially adjusted models [AOR=2.00, 95% CI: 1.03-3.90], the association lost its significance [AOR=1.89, 95% CI: 0.92-3.87] in the fully adjusted model.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePharmacotherapy remains essential in controlling hypertension. Non-adherence to antihypertensive medications, guideline discordant therapy, and polypharmacy independently increase patients’ risk of uncontrolled hypertension. 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