Medication Non-Adherence Among Hypertensive Ghanaian Un Peacekeepers

ABSTRACT

Medical fitness of troops participating in UN peacekeeping mission is of paramount importance to commanders on the field for efficient and productive execution of set tasks. Disability resulting from complications of chronic illnesses, markedly reduces the number of active troops, which includes highly trained specialists, hence commanders fail to achieve targeted objectives. The objective of this study was to estimate the prevalence of hypertension among Ghanaian – UN peacekeepers and assess the level of anti-hypertensive medication non-adherence among the known hypertensive personnel serving on UN peacekeeping mission. This study was conducted using a descriptive cross-sectional method. Using a power survey calculator, 1207 filled pre-deployment medical examination forms for troops embarking on UN peacekeeping mission were sampled for the determination of prevalence of hypertension among personnel of the Ghana Armed Forces. One hundred and thirty two personnel took part in the medication non-adherence study. Quantitative and nominal data were collected using filled pre-deployment screening medical forms for troops embarking on UN peacekeeping missions as well as close-ended structured questionnaire and an adapted modified Morisky’s scale for measuring adherence level to medication regimen.

The prevalence of hypertension was estimated to be 30% among troops embarking on UN peacekeeping mission. The mean systolic pressure was 173.23 mmHg with a standard deviation of 17.81 and the mean diastolic pressure of 104.18 mmHg and with a

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standard deviation of 11.83. The proportion of hypertensive personnel were 50% and 69% in the age groups 40 – 54 and 55 – 59 years respectively. Increasing Age and BMI were significantly associated with prevalence of hypertension. The level of non-adherence exhibited by peacekeepers was extremely high (98.4%). In this study, the level of knowledge about hypertension and its management was very significantly associated with anti-hypertensive medication non-adherence (P-value < 0.001). Rank was also very significantly associated with adherence, with Senior Non Commissioned Officers were 4.48 times more likely to adhere compared to their junior counterparts and this rose to 5.23 after adjusting for other variables. In conclusion, half of the service personnel recruited into the Ghana Armed Forces were likely to become hypertensive after 40 years of age. Robust and targeted interventional education programs need to be developed for the various age groups especially the younger age groups which this study found to be four times less likely to adhere to prescribed anti-hypertensive drugs, in order to achieve primary and secondary prevention of hypertension. Assessment of the Instituted Claims System for purchased drugs clearly showed there is need for modification with optional suggestions.