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Table 2 Factors inhibiting adherence to medications: thematic matrix of categories, subcategories and concepts (n = 40)

From: Perceptions of inhibitors and facilitators for adhering to hypertension treatment among insured patients in rural Nigeria: a qualitative study

Category

Sub-category

Concepts

1) Healthcare related factors

Inflexible clinic hours

Clinic visits always coincide with religious worship time [n = 3]*

Works/farm during clinic hours [n = 10]

Difficult to refill drugs for longer periods when travelling out of town [n = 6]

 

Long waiting time

Less time available for business or other important activities [n = 31]

Logistics/ travel costs constraints

Residence too far from clinic [n = 4]

 

Medications out of stock

Under dispensed prescriptions [n = 11]

Prescribed pills not dispensed [n = 3]

2) Patient related factors

Poor knowledge about hypertension

Hypertension is curable, transient [n = 23]

Feels well, no symptoms, so don’t use pills [n = 3]

3) Medication related factors

Adverse effects, side effects

Abandon pills to avoid intolerable effects [n = 7]

 

Complexity of prescription regimes

Too many pills prescribed, too frequent dosing to follow [n = 6]

 

Substitution/supplementation of prescribed medicines

Takes herbal drugs alongside prescribed pills [n = 5]

Takes herbal drugs in place of prescribed pills [n = 2]

4) Religion related factors

Medication use discouraged by faith practice

Believes in faith healing [n = 2]

Dosing frequency incompatible with faith practice (fasting) [n =13]

5) Social factors

None or poor social support

Wife lacks husband’s approval (which is) mandatory for outings – clinic visits [n = 1]

  1. *n refers to the number of respondents whose perceptions contribute to the corresponding concepts.