The Predictive Effect of Pharmacotherapy-Related Factors on Uncontrolled Hypertension among Hypertensive Patients on Treatment in the Sekyere East District, Ghana: A Facility-Based Analytical Cross-Sectional Survey

Background Clinical guidelines recommend pharmacotherapy as the primary intervention for hypertension control once blood pressure exceeds treatment thresholds. However, many patients on treatment still present with uncontrolled hypertension, which remains a major cause of adult hospitalisations and cardiovascular complications in Ghana. This study, therefore, assessed the predictive effect of pharmacotherapy-related factors on uncontrolled hypertension among patients receiving treatment at the Effiduase District Hospital in Ghana. Methods An analytical cross-sectional study was conducted at the Effiduase District Hospital. Stratified random sampling was employed to sample 453 hypertensive patients on treatment. Data were collected using a questionnaire and a medical records review. Two nested logistic regression models were applied to identify the predictive effect of pharmacotherapy on uncontrolled hypertension. Pharmacotherapy-related variables that remained statistically significant in the fully adjusted model (p < 0.05), along with adjusted odds ratios and corresponding 95% confidence intervals, were considered independent predictors of uncontrolled hypertension. Results The magnitude of uncontrolled hypertension was 33% (n=154). In the fully adjusted model, medication non-adherence [AOR=2.06, 95% CI:1.29-3.29 ] , polytherapy [AOR=19.00, 95% CI:4.38-82.43] and guideline discordant prescription [AOR=3.40, 95% CI: 1.29-8.91] were independently associated with increased odds of uncontrolled hypertension Medication financing was associated with uncontrolled hypertension in the unadjusted [COR=1.92, 95% CI: 1.04-3.53] and the partially adjusted models [AOR=2.00, 95% CI: 1.03-3.90], the association lost its significance [AOR=1.89, 95% CI: 0.92-3.87] in the fully adjusted model. Conclusion Pharmacotherapy remains essential in controlling hypertension. Non-adherence to antihypertensive medications, guideline discordant therapy, and polypharmacy independently increase patients’ risk of uncontrolled hypertension. This highlights the importance of patient-level self-management behaviours regarding medications and the need for prescribers to follow evidence-based treatment guidelines to achieve optimal hypertension control.