Adherence to Self-Care among Patients with Hypertension in Ethiopia: A Systematic Review and Meta-Analysis

Abstract

Background. Self-care adherence for hypertensive patients is a cornerstone for the control of it and prevention of its complications. However, there are inconsistent findings for self-care adherence of hypertensive patients in Ethiopia. Thus, this systematic review and meta-analysis was done to determine the pooled estimate self-care adherence. Methods. This systematic review and meta-analysis was reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. An intensive search of online databases such as PubMed (MEDLINE), CINHAL, Google Scholar, and advanced Google search was made to access both published and unpublished articles that report self-care adherence among hypertensive patients in Ethiopia. The pooled estimate was done with STATA version 11 metan commands in a 95% confidence interval. The presence of heterogeneity and publication bias were detected by I2 and Egger’s test, respectively. A random-effect model was obtained, and subgroup analysis was done for the management of heterogeneity. Result. A total of 24 articles with a total of 7224 participants were included in the final systematic review and meta-analysis. The pooled estimate of overall self-care adherence among hypertensive patients was 36.98% (95% CI: 27.13–46.83). In subgroup analysis, the highest overall self-care adherence was observed in the Amhara region at 53% (95% CI: 46.54, 59.47). The pooled estimate of self-care dimensions such as medication adherence, low-salt diet, physical activity, smoking abstinence, alcohol abstinence, and weight management was 62.71%, 65.96%, 47.28%, 92.53%, 67.59%, and 52.54%, respectively. Conclusion. The pooled estimate of good self-care adherence among hypertensive patients was low. From the dimensions of self-care, the lowest level was in physical activity and the highest level was in smoking abstinence. Comparing all regions, the lowest level of overall self-care adherence was observed in Addis Ababa, Tigray region, and South Nations and Nationalities of Ethiopia. Screening of adherence to self-care and health education should be provided to every patient during every visit.

Predictors of blood pressure control and antihypertensive drug adherence among hypertensive patients: Hospital-based cross-sectional study

“…Those participants who added additional salt to the plate were more adherent (P<0.01). In this study, the rate of dietary salt restriction was 40% which is higher than reported from two meta-analysis and systematic review studies which was 34% [32] and 37.3% [33]. However, no data report showed an association with medication adherence.…”

Level of household’s head satisfaction and associated factors towards Community-Based Health Insurance (CBHI) schemes among enrollees in Northwest Ethiopia. A community- based cross-sectional study

“…This nding is supported by previous studies conducted in Ethiopia (12) and Ghana (21,29). Evidence shows that implementation of the Compassionate, Respectful, and Caring (CRC) CRC increases patient satisfaction (30).…”

Understanding Patient Adherence to Hypertension Management Guidelines

“…The management of hypertension involves multifaceted strategies that encompass lifestyle modifications and adherence to prescribed medication regimes (Jarari et al, 2015;Ks et al, 2021;Midlöv et al, 2008;Milchak et al, 2006). Despite the critical importance of managing this condition, adherence to hypertension management guidelines by both healthcare providers and patients is less than optimal, leading to significant morbidity and mortality (Adedeji et al, 2015;Drawz et al, 2009;Edmealem et al, 2022;Ibezim et al, 2020).…”

“…From the patient's viewpoint, adherence to hypertension management is influenced by personal beliefs, understanding of the disease, socioeconomic factors, and the perceived complexity of the treatment regime. Studies by Nguyen et al (2017) and Edmealem et al (2022) demonstrate that cultural beliefs, economic constraints, and educational levels significantly impact patient adherence to prescribed management plans (Edmealem et al, 2022;Nguyen et al, 2017). Furthermore, evidence emphasize the role of patient education and health literacy as critical factors in enhancing adherence cannot be understated (Cheng & Chiang, 2015;Crowley et al, 2012).…”