Prevalence and determinants of medication adherence among women with hypertension attending urban primary health care facilities in Inezgane, Morocco: a cross-sectional study.

INTRODUCTION: Cardiovascular diseases remain the leading cause of death globally, with hypertension representing a major modifiable risk factor. Medication adherence persists as a major challenge in hypertension management, particularly among women, who often face unique barriers to adherence. This study aimed to estimate the prevalence of antihypertensive medication adherence and to identify its associated factors among Moroccan women with hypertension. METHODS: A cross-sectional study was conducted in January 2025 among women attending three urban primary health care facilities in Inezgane, Morocco. The 8-item Morisky Medication Adherence Scale (MMAS-8) was used to assess medication adherence. Descriptive statistics summarized participants' characteristics, and logistic regression analyses were performed to identify adherence-related factors. RESULTS: Among 364 hypertensive Moroccan women with a median age of 58 years (IQR: 48-65), 53.3% were non-adherent to their antihypertensive treatment. Multivariable analyses revealed that having health insurance (AOR 1.87; CI 1.19-2.95; p = 0.007) and participation in therapeutic education sessions (AOR 2.21; CI 1.27-3.83; p = 0.005) were associated with improved adherence. Conversely, polytherapy (AOR 0.14; CI 0.06-0.30; p < 0.001) and multiple daily doses (AOR 0.35; CI 0.20-0.61; p < 0.001) were associated with lower adherence. CONCLUSION: More than half of the population of this study exhibited low adherence to antihypertensive medication. Multifaceted interventions, including enhanced patient education, simplified drug protocols, and improved healthcare accessibility, are required to improve adherence among Moroccan hypertensive women.