Open Journal of Epidemiology, 2017, 7, 211-250 http://www.scirp.org/journal/ojepi ISSN Online: 2165-7467 ISSN Print: 2165-7459 DOI: 10.4236/ojepi.2017.73018 Aug. 9, 2017 211 Open Journal of Epidemiology A Systematic Review of Factors Influencing Medication Adherence to Hypertension Treatment in Developing Countries Lipi Dhar, Jaya Dantas, Mohammed Ali International Health Programme, Faculty of Health Sciences, Curtin University, Bentley, Australia Abstract Background: Coronary heart disease (CHD), a complication of hypertension, is one of the most important and common causes of morbidity, hospitalisa- tion, and mortality among hypertensive population. In recent decades, in- creased urbanisation and changes to lifestyle, diet and physical activity in de- veloping countries have led to a major increase in the population incidence of chronic diseases including CHD. Poor medication adherence is one of the leading causes of failure to achieve hypertension control. The objective of this systematic review is to describe the prevalence of non-adherence to anti- hypertensive medications among hypertensive population in developing coun- tries and identify factors associated with it. Methods: A literature search was conducted using the following scholarly electronic databases: Proquest, Pub- Med, JSTOR and Science Direct. The online search engine, Google Scholar was also used to search for and identify relevant papers. Peer-reviewed full- text articles published in English on hypertensive adults in developing coun- tries that measured adherence to antihypertensive medications and their asso- ciations with different factors were eligible for inclusion. The review followed the PRISMA reporting and analytical guidelines for systematic reviews. Re- sults: In all, 42 studies conducted across 19 developing countries were selected for the review. The mean prevalence of medication non-adherence (MNA) among the select hypertensive population was 47.34%. Very few studies were conducted in community settings and except for one, no study examined gender differences in MNA factors. The analysis revealed a range of factors that can influence MNA including low household income and socioeconomic status; knowledge and beliefs of hypertension and its management; avoiding side effects of medications; cost of medication; use of herbal preparations; ab- sence of symptoms; irregular follow-up; and dissatisfaction with the treatment and health services provided. There was a general lack of consideration of role of health system in health care delivery, self-efficacy, cultural barriers, per- How to cite this paper: Dhar, L., Dantas, J. and Ali, M. (2017) A Systematic Review of Factors Influencing Medication Adherence to Hypertension Treatment in Developing Countries. Open Journal of Epidemiology, 7, 211-250. https://doi.org/10.4236/ojepi.2017.73018 Received: May 18, 2017 Accepted: August 6, 2017 Published: August 9, 2017 Copyright © 2017 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access