{
  "abstract": "BackgroundHypertension is a leading modifiable risk factor for cardiovascular disease and premature death worldwide. Despite effective pharmacological therapy, poor adherence to anti-hypertensive medication remains the primary barrier to achieving blood pressure control, with non-adherence rates reaching 45-65% in sub-Saharan African settings. In Zambia, uncontrolled hypertension contributes substantially to hospital morbidity and mortality, yet context-specific data on adherence barriers remain limited. This study assessed factors associated with adherence to anti-hypertensive medication among patients attending Railway Surgery Urban Health Centre in Ndola, Zambia.\n\nMethodsA cross-sectional study was conducted among 237 hypertensive patients attending Railway Surgery Urban Health Centre in Ndola. A structured, interviewer-administered questionnaire assessed socio-demographic characteristics, clinical factors, and medication adherence using the modified Hill-Bone Compliance Scale. Data were analysed using descriptive statistics, chi-square tests, and multivariable logistic regression (p<0.05).\n\nResultsThe overall adherence rate was 41.4%, with 58.6% of participants classified as non-adherent. The mean adherence score was 19.8 (SD=4.6) out of a possible 32. The most common reasons for non-adherence were running out of pills (mean=2.6), being away from home (mean=2.5), and forgetting to take medication (mean=2.4). Age (p=0.006), education level (p=0.001), and monthly income (p=0.001) were significantly associated with adherence. Clinical factors significantly associated with poorer adherence included presence of comorbidities (p=0.027), experience of side effects (p<0.001), and medication regimen complexity (p=0.007). Multivariable analysis identified age [≥]51 years (AOR=2.89-3.24), secondary/tertiary education (AOR=2.84-3.56), monthly income [≥]K1,000 (AOR=2.21-5.89), absence of comorbidities (AOR=0.51), absence of side effects (AOR=0.36), and simpler regimens (AOR=0.34) as factors independently associated with adherence. Health system barriers included long distances, reliance on public transport, missed appointments due to transport problems (35.4%), medication stock-outs (38.4%), and inadequate counselling time (49.8% received <5 minutes).\n\nConclusionAdherence to anti-hypertensive medication at Railway Surgery Urban Health Centre is suboptimal, with multiple socio-demographic, clinical, and health system factors associated with non-adherence. Interventions should focus on regimen simplification, proactive side effect management, enhanced patient education, and addressing systemic barriers including medication supply and transport access.",
  "abstract_shown": true,
  "affiliations": [
    "Chreso University"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "N. Sikantongwe"
    },
    {
      "name": "E. Musonda"
    },
    {
      "name": "F. Mabaso"
    },
    {
      "name": "E. Chibwaya"
    },
    {
      "affs": [
        0
      ],
      "name": "E. Sikantongwe"
    },
    {
      "name": "C. Mapiki"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a0g7xmdn0c74g.bib",
  "cited_by": 1,
  "doi": "10.64898/2026.09.11.26362862",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.11.26362862v1.full",
  "id": "a0g7xmdn0c74g",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.11.26362862v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "cardiovascular medicine"
    ],
    [
      "openalex",
      "2714|Medication Adherence and Compliance"
    ]
  ],
  "openalex": "W7213456162",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.11.26362862v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-11",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/a0g7xmdn0c74g.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:47Z",
      "native_id": "10.64898/2026.09.11.26362862",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.11.26362862v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:cardiovascular medicine",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Factors Associated with Adherence to Anti-Hypertensive Medication Among Patients Attending a Primary Health Centre in Ndola, Zambia: A Cross-Sectional Study",
  "title_text": "Factors Associated with Adherence to Anti-Hypertensive Medication Among Patients Attending a Primary Health Centre in Ndola, Zambia: A Cross-Sectional Study",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:47Z",
  "url": "https://research.draconitic.com/paper/a0g7xmdn0c74g",
  "venue": "medRxiv",
  "versions": []
}