An assessment of adherence to antihypertensive treatment and associated factors in patients at the Yaounde general hospital

REPUBLIQUE DU CAMEROUN

Paix - Travail - Patrie

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UNIVERSITE DE YAOUNDE I

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FACULTE DE MEDECINE ET DES

SCIENCES BIOMEDICALES

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AN ASSESSMENT OF ADHERENCE TO ANTIHYPERTENSIVE TREATMENT AND ASSOCIATED FACTORS IN PATIENTS AT THE YAOUNDE GENERAL HOSPITAL

Presented by:

CHIABI ROLAND MUNTOH

7^TH YEAR PHARMACY STUDENT

Thesis Presented and Defended Publicly in Partial Fulfilment of the Requirements for the Award of a Pharmaciae Doctor (Pharm.D.) Degree

CO-SUPERVISOR

Dr. TEMBE Estella épse FOKUNANG

Senior Lecturer of Clinical Pharmacology

SUPERVISOR

Prof. MENANGA Alain Patrick

Associate Professor of Cardiology

Academic year: 2017-2018

TABLE OF CONTENT

PREFACE ii

DEDICATION iii

ACKNOWLEDGEMENTS iv

LIST OF ADMINISTRATIVE AND ACADEMIC STAFF OF THE FACULTY OF MEDICINE AND BIOMEDICAL SCIENCES FOR THE 2017/2018 ACADEMIC YEAR v

GALEN'S OATH xvi

ABSTRACT xvii

RESUME xix

LIST OF FIGURES xxi

LIST OF TABLES xxii

LIST OF ABBREVIATIONS/ACRONYMS/SYMBOLS xxiii

CHAPTER I: INTRODUCTION 1

I.1 BACKGROUND AND RATIONALE 1

I.2 RESEARCH QUESTION 4

I.3 RESEARCH HYPOTHESIS 4

I.4 OBJECTIVES 4

CHAPTER II: LITERATURE REVIEW 5

CHAPTER III: MATERIALS AND METHOD 50

CHAPTER IV: RESULTS 59

CHAPTER V: DISCUSSION 75

CHAPTER VI: CONCLUSION AND RECOMMENDATIONS 81

CHAPTER VII: REFERENCES 84

CHAPTER VIII: APPENDIX 97

PREFACE

DEDICATION

This scientific project is dedicated to my parents.

ACKNOWLEDGEMENTS

I thank GOD ALMIGHTY for His unceasing love, for keeping strong and healthy and for His numerous graces shown to me throughout these years of pharmacy training.

This work will not have been a success without the contributions of the following people:

Ø My supervisor, Prof MENANGA Alain, for his continuous support, patience, motivation and immense knowledge. His guidance helped me throughout the research period and also during the writing of this thesis. I could not have imagined having a better advisor and mentor for my end of course thesis.

Ø My cosupervisor, Dr. TEMBE Estella, for her insightful comments and encouragements but also for the hard questions which motivated me to widen my research from various perspectives! Thank you Doctor for being a mentor for me and for sharing your experiences with me throughout these years. I am forever grateful.

Ø The cardiologists and the nurses of the external consultation unit, who facilitated my integration into the healthcare team. Without their precious support it would not have been possible to conduct this research.

Ø All the participants in my study, who willingly spared their precious time to answer my questions.

Ø All the lecturers of the Faculty of Medicine and Biomedical Sciences (FMBS) for grooming me throughout these years of pharmaceutical studies.

Ø My parents for all the sacrifices, encouragements and support they have made on my behalf. Your prayers for me was what sustained me this far.

Ø My brothers, CHIABI Edmond, CHIABI Valery and CHIABI Leslie, and the rest of my family for their support and the love they have always been showing me.

Ø Dr. NGANGUE NSEKE Rose, Dr. ABONG BWEMBA Therese and Dr. KIMA Tessa for their mentorship, assistance, and dedicated involvement in one level or another in my training. I would like to thank you very much for your support, advice and understanding throughout these years.

Ø All my classmatesand friends for the love, the friendship, the support, the stimulating scientific discussions, the fun and the patience.

Ø The Director of the Yaounde General Hospital for granting me the authorization to pursue this research.

Ø Mr TCHUISSEU Frederic for the statistical analysis.

Ø All those who contributed in the elaboration of this work.