Original Research Adherence to hypertension management at a rural hospital in Limpopo: A cross-sectional study

Murendeni F. Sikhau, Mbuyisa J. Makhubu, Gert J.O Marincowitz, Clara Marincowitz

South African Family Practice | Vol 67, No 1 : Part 3| a6136 | DOI: https://doi.org/10.4102/safp.v67i1.6136 | © 2025 Murendeni F. Sikhau, Mbuyisa J. Makhubu, Gert J.O. Marincowitz, Clara Marincowitz | This work is licensed under CC Attribution 4.0
Submitted: 15 February 2025 | Published: 18 August 2025

About the author(s) Murendeni F. Sikhau, Department of Family Medicine, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
Mbuyisa J. Makhubu, Department of Family Medicine, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
Gert J.O Marincowitz, Department of Family Medicine, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
Clara Marincowitz, Department of Biological Sciences, Faculty of Science, University of Cape Town, Cape Town, South Africa

Abstract

Background: Non-adherence to treatment remains a major contributing factor to uncontrolled hypertension and its complications. In South Africa, an estimated 50% of adults are living with hypertension and between 41.9% and 45.5% adhere to their treatment. Knowing reasons for non-adherence, therefore, is important in the treatment of hypertension.

Methods: A cross-sectional study involving 243 hypertensive patients was conducted from May to July 2022 at Voortrekker Hospital, Mokopane, Limpopo province. The questionnaire included socio-demographic and hypertension-related medical information and adherence was assessed using the previously validated Therapeutic Adherence Scale for Hypertensive Patients (TASHP).

Results: Forty-two per cent of participants adhered to their antihypertensive treatment, whereas 56% controlled their blood pressure. Variables such as employment (p = 0.0076), secondary and tertiary education (p = 0.0048), duration of hypertension of less than a year (p = 0.019) and level of income (more than R3000/month) (p = 0.033) were significantly associated with better adherence.

Conclusion: Adherence to treatment and blood pressure control among hypertensive patients in the Mokopane area is still inadequate, although within the same range as reported in the literature. Effective strategies must be developed to address adherence, especially for vulnerable patients.

Contribution: The study identified that only 42% of patients in a rural district hospital setting adhere to their hypertension management. Furthermore, it was found that patients less educated, unemployed, having an income of less than R3000/month or living with hypertension for more than 15 years are significantly more vulnerable to poor adherence.

Keywords

hypertension; adherence to treatment; South Africa; rural; district hospital

Sustainable Development Goal

Goal 3: Good health and well-being

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