Abstract

Hypertension is a leading chronic disease in Nigeria, where poor access to care and limited adherence undermine
health outcomes. Telemedicine has been proposed as a strategy to strengthen diagnosis, adherence, and continuity
of care. A structured questionnaire was administered to hypertensive adults in Kebbi State. Logistic regression
was used to examine the influence of awareness on telemedicine adoption and the relationship between perceived
effectiveness and reported outcomes. Hierarchical log-linear modeling (HLLM) was applied to explore
categorical associations among diagnosis status, duration since diagnosis, and current medication use. Awareness
strongly predicted telemedicine usage (Nagelkerke R²=0.824, overall classification accuracy=88%). Patients
rating telemedicine as “very effective” were more than four times as likely to report positive outcomes compared
with those rating it “ineffective” (OR=4.23, 95% CI: 1.63–10.9). HLLM results showed significant main effects
for diagnosis status, duration, and medication use, but only the Diagnosis×Medications interaction was significant
(χ²(5)=65.55, p

Key words: Hypertension, Telemedicine, Awareness, Logistic Regression, Hierarchical Log-Linear Modeling