Prevalence and Predictors of Polypharmacy, Self-medication, and Poor Medication Adherence among Hypertensive Patients of Bangladesh

Background Hypertension, a highly prevalent yet preventable risk factor for numerous diseases, affects approximately 1.28 billion adults globally, with a disproportionate burden in low- and middle-income countries such as Bangladesh. This study aims to assess the prevalence and determinants of polypharmacy, self-medication, and medication adherence among adults with hypertension to improve treatment outcomes and enhance patients’ quality of life. Materials and Methods A total of 496 adult hypertensive patients on anti-hypertensives were recruited using convenience sampling from ten government hospital outpatient clinics and ten private physicians’ offices throughout Bangladesh participated in this cross-sectional study. Data were collected by face-to-face interview using a semi-structured questionnaire containing demographic questions, the Medication Adherence Report Scale (MARS-5), a self-medication evaluation tool, and a comprehensive medication history record. Collected data were analyzed using Stata (version 17). Results The mean age of the participants were 54.26 ± 11.90, with 54.04% (273) being male. Self-medication, poor adherence, and polypharmacy were observed in 88.9%, 55.9%, and 20.0% of the participants, respectively. Poor adherence was associated with self-medication (AOR 0.27; 95% CI 0.14–0.53) and disability (AOR 0.38; 95% CI 0.19–0.78), and was improved by satisfaction with healthcare (AOR 2.27; 95% CI 1.16–4.44) and family history of chronic disease (AOR 1.78; 95% CI 1.18–2.68). Self-medication was more likely among those dissatisfied with medicines (AOR 5.06; 95% CI 1.57–16.33) and facing financial difficulty (AOR 2.06; 95% CI 1.02–4.13). Polypharmacy increased with age (AOR 1.04; 95% CI 1.01–1.07), sub-urban (AOR 2.87; 95% CI 1.16–7.10) and urban residence (AOR 2.65; 95% CI 1.21–5.84), multimorbidity, and family history (AOR 1.90; 95% CI 1.12–3.23). Conclusion