Published in PLOS One on 2026-06-24, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Cynthia Serwaa Akoto Osei, Jacob Solomon Idan, Edmund Baah-Akyeamfour, Bhavana Singh, Daniel Boateng
Source: PLOS One • DOI 10.1371/journal.pone.0351632
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Hypertension poses significant challenges to quality of life globally. While medication adherence is essential for managing hypertension, psychosocial factors like family support may influence both adherence and quality of life. This study investigated the mediating role of family support in the relationship between medication adherence and quality of life among persons with hypertension in Ghana.
A cross-sectional study was conducted among 365 patients with hypertension attending Kwame Nkrumah University of Science and Technology Hospital in Kumasi, Ghana. Data were collected using structured questionnaires, including the Short Form-36 for quality of life assessment, the Family Adaptation, Partnership, Growth, Affection, Resolve scale for family support measurement, and the Morisky Medication Adherence Scale. Mediation analysis was performed using R statistical software.
Five models with increasing levels of adjustment were constructed for the mediation analysis. Higher medication adherence was significantly associated with better quality of life (Total Effect: (β) = 1.07, 95% CI: 0.63–1.50, p < 0.001). Family support significantly mediated this relationship (Average Causal Mediation Effect = 0.09, 95% CI: 0.02–0.19, p = 0.008), accounting for 8% of the total effect. The direct effect of medication adherence on quality of life remained significant after adjusting for family support (Average Direct Effect = 0.98, 95% CI: 0.52–1.42, p < 0.001). The mediation effect persisted after adjusting for socio-demographic characteristics, knowledge score, healthcare access, and lifestyle factors (mediated proportion: 8.9%, p = 0.038). Patients from highly functional families demonstrated better quality of life with a unit increase in medication adherence score.
Family support partially mediates the relationship between medication adherence and quality of life of persons with hypertension. Interventions to improve medication adherence and quality of life should incorporate strategies to enhance family support systems. Healthcare providers should consider the complex family dynamics when developing comprehensive management plans for persons with hypertension.
Introduction
Hypertension is a major public health challenge globally with prevalence of 34.1%, particularly in low- and middle-income countries (LMICs) and Sub-Saharan Africa (SSA) [1–3]. The African regional prevalence is estimated at 27% [4]. In Ghana, the prevalence of hypertension is estimated at 34% across different regions, with the elderly populations experiencing higher rates [4,5]. The prevalence is estimated at 37.4% in Ashanti region [2]. Hypertension significantly affects patients’ quality of life (QoL), encompassing physical, psychological, and social well-being [2,6]. Medication adherence, defined as the extent to which patients take medications as prescribed by healthcare providers, is crucial for effective hypertension management and quality of life [7]. Poor adherence to antihypertensive medications is associated with uncontrolled blood pressure, increased risk of complications (heart disease, cerebrovascular accidents, kidney disease), and reduced QoL [8]. While pharmacological treatments for hypertension are available, their therapeutic benefits are linked to patient adherence behaviors [8].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Cynthia Serwaa Akoto Osei, Jacob Solomon Idan, Edmund Baah-Akyeamfour, Bhavana Singh, Daniel Boateng. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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