Disease Management and Treatment Adherence Outcomes among Hypertensive and Diabetic Patients in a Semi-rural Hospital, Akwanga, Nasarawa State, Nigeria

Abstract

Aims: This study assessed disease management and treatment adherence outcomes among hypertensive and diabetic patients attending Our Lady of Apostle (OLA) Hospital, a semi-rural healthcare facility in Akwanga, Nasarawa State, Nigeria, and examined the barriers patients face in accessing healthcare services and adhering to treatment protocols. Study Design: This was a descriptive cross-sectional survey combining quantitative and qualitative approaches, anchored in the Health Belief Model (HBM). Place and Duration of Study: Our Lady of Apostle (OLA) Hospital, Akwanga, Nasarawa State, Nigeria, between January 2025 and November 2025. Methodology: The study population comprised 3,074 registered hypertensive and diabetic patients and healthcare providers at OLA Hospital. Using the Krejcie and Morgan sample size determination table, a sample size of 341 was estimated; 300 respondents were purposively selected and administered a structured questionnaire, and 295 copies (96%) were valid for analysis. A four-item oral interview guide was also administered to 41 healthcare providers during Focus Group Discussions (FGDs). Data were analysed using frequency counts and simple percentages. Results: Of the 295 respondents, reduced cardiovascular risk (38.98%), decreased mortality rate (27.1%), improved quality of life (21%) and regular monitoring (12.88%) were identified as the major outcomes of disease management and treatment adherence. Regarding barriers to accessing healthcare and adhering to treatment protocols, limited healthcare insurance coverage and resources (33.8%), shortage of specialised healthcare providers (30.84%), cultural beliefs (25.8%) and inadequate technological know-how (10.16%) were identified. Findings from the Focus Group Discussions corroborated these results, with healthcare providers reporting that patient awareness status, reduced cardiovascular risk, improved quality of life, decreased mortality and improved regular monitoring characterised management outcomes, and recommending constant staff training, medication-adherence awareness campaigns and community engagement as strategies to reduce complication rates. Conclusion: Disease management and treatment adherence among hypertensive and diabetic patients attending a semi-rural Nigerian hospital yield measurable benefits, including reduced cardiovascular risk, decreased mortality and improved quality of life, but these gains are constrained by limited insurance coverage, a shortage of specialised healthcare providers, and persistent cultural beliefs. Strengthening healthcare workforce capacity, expanding insurance coverage, and community-based adherence support are recommended to improve treatment outcomes in semi-rural Nigerian healthcare facilities.