Antihypertensive Medication Adherence and Associated Factors: A Cross-Sectional Analysis of Patients Attending a National Referral Hospital in Asmara, Eritrea

Mebrahtu, Goitom; Moleki, Mary; Achila, Oliver Okoth; Seyoum, Yemane; Adnoy, Elias T; Ovberedjo, Martin

doi:10.2147/ppa.s319987

Cited by 5 publications

(13 citation statements)

References 32 publications

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“…Our finding of the positive association between non-adherence and daily intake of multiple AHMs is consistent with studies from Korea [ 20 ], Malaysia [ 39 ], Lebanon [ 23 ], and elsewhere [ 11 , 18 , 21 , 24 ]. The everyday use of multiple daily medications is an essential intervention to decrease cardiovascular complications in patients with poorly controlled hypertension.…”

Section: Discussionsupporting

confidence: 92%

“…Depression is common in patients with hypertension and is associated with a poorer prognosis and higher healthcare costs [ 44 , 45 ]. As previously reported in other studies [ 11 , 23 , 24 , 26 ], the presence of depressive symptoms was associated with non-adherence to AHMs. Given the high prevalence of depression in Afghan society, this effect is highly relevant [ 46 ].…”

Section: Discussionsupporting

confidence: 82%

“…The relationship between mental and physical health is complex. Addressing mental health concerns such as depression is important for the patient’s general well-being and may also be a catalyst for increasing adherence to physical health medical treatments [ 23 , 24 ]. Hence, screening and early identification of hypertensive patients with depressive symptoms are paramount to circumvent non-adherence to AHMs and their bio-psycho-social sequelae.…”

Section: Discussionmentioning

confidence: 99%

“…A fair amount of data in the developing world indicate that diverse factors such as age [ 11 , 20 ], sex [ 11 , 21 , 22 ], marital status [ 11 , 23 ], employment status [ 11 , 24 ], area of residence [ 11 , 20 ], education [ 11 , 25 ], health facility distance [ 21 ], household income [ 11 , 22 ], Body Mass Index (BMI) [ 23 , 24 ], physical activity [ 11 , 20 ], alcohol consumption [ 22 ], smoking [ 11 ], comorbidity [ 11 , 20 – 22 ], salt intake [ 11 , 20 ], family history of hypertension [ 11 ], hypertension duration [ 11 ], number of AHMs [ 11 , 20 – 22 ], stage of the disease [ 11 ], knowledge about hypertension and its treatment [ 21 , 24 , 25 ], history of depressive symptoms [ 11 , 23 , 24 , 26 ], hypertension-linked cost [ 11 , 22 , 24 , 25 ], social support [ 23 , 26 ], and client satisfaction [ 25 ] are associated with adherence to AHMs.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of non-adherence to antihypertensive medications: A cross-sectional study from a regional hospital in Afghanistan

Stanikzai,

Wafa,

Tawfiq

et al. 2023

PLoS ONE

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Background Non-adherence to antihypertensive medications (AHMs) is a widespread problem. Cardiovascular morbidity and mortality reduction is possible via better adherence rates among hypertensive patients. Objectives This study aimed to assess the prevalence of non-adherence to AHMs and its predictors among hypertensive patients who attended Mirwais Regional Hospital in Kandahar, Afghanistan. Methods A cross-sectional study using random sampling method was conducted among hypertensive patients, aged ≥18 years in Mirwais Regional Hospital at a 6-month follow-up between October and December 2022. To assess non-adherence to AHMs, we employed the Hill-Bone Medication Adherence scale. A value below or equal to 80% of the total score was used to signify non-adherence. A multivariable binary logistic regression model was used to identify predictors of non-adherence to AHMs. Results We used data from 669 patients and found that 47.9% (95%CI: 44.1–51.8%) of them were non-adherent to AHMs. The majority (71.2%) of patients had poorly controlled blood pressure (BP). The likelihood of non-adherence to AHMs was significantly higher among patients from low monthly-income households [Adjusted odds ratio (AOR) 1.70 (95%CI: 1.13–2.55)], those with daily intake of multiple AHMs [AOR 2.02 (1.29–3.16)], presence of comorbid medical conditions [AOR 1.68 (1.05–2.67), lack of awareness of hypertension-related complications [AOR 2.40 (1.59–3.63)], and presence of depressive symptoms [AOR 1.65 (1.14–2.38)]. Conclusion Non-adherence to AHMs was high. Non-adherence to AHMs is a potential risk factor for uncontrolled hypertension and subsequent cardiovascular complications. Policymakers and clinicians should implement evidence-based interventions to address factors undermining AHMs adherence in Afghanistan.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictors of non-adherence to antihypertensive medications: A cross-sectional study from a regional hospital in Afghanistan

Stanikzai,

Wafa,

Tawfiq

et al. 2023

PLoS ONE

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“… 39 Previous research has also demonstrated that poor health education in the communities is a major factor in non-compliance. 40 In Saudi Arabia, to minimize the direct contact with healthcare centers and to improve the access to healthcare, Saudi government took several initiatives such as expansion of telemedicine services to the community during the pandemic. However, access to such services was restricted in rural areas and mainly people living in urban areas benefitted from this alternative source of healthcare.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life and Adherence to Healthcare Services During the COVID-19 Pandemic: A Cross-Sectional Analysis

Hassan¹,

Zahra²,

Parveen³

et al. 2022

PPA

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Purpose To determine the relationship of various domains of quality of life (QoL) with healthcare adherence during the COVID-19 pandemic in Saudi Arabia. Methods The study sample comprised 795 participants among which 203 had a current diagnosis of any major NCDs, including cardiovascular diseases, diabetes mellitus, asthma, chronic pulmonary diseases, and chronic psychiatric illnesses and a control group of 592 participants who had no NCD. Participants completed an online survey questionnaire which obtained data on socio-demographic variables, types of NCDs, and healthcare adherence during the year 2020, the period during which Saudi Arabia underwent the first two waves of the COVID-19 pandemic. World Health Organization Quality of Life (WHOQOL-BREF) assessed the QoL in four domains physical, psychological, social and environmental and used standard scores in the analysis. GraphPad Prism 5 and SPSS 25V were employed for the statistical analysis. Bar graphs and frequency distribution tables present descriptive data. Bivariate and multivariate logistic regression analyses were computed to determine the significance of the relationship between QoL and healthcare adherence. Results Almost equal proportions of participants with NCDs (n=109/203; 54%) and without NCDs (n=327/592; 55%) demonstrated nonadherence to their regular healthcare during the COVID-19 pandemic (χ2=0.14; p=0.71). Patients with NCDs experienced lower quality of life in the psychological, social and environmental domains of QoL (p<0.05). Results from the multivariate regression analysis showed that female gender (AOR=1.52; p<0.05) psychological QoL (AOR=1.99; p<0.05), social QoL (AOR=1.98; p<0.05) and environmental QoL (AOR=1.95; p<0.05) significantly relate with adherence to healthcare. Conclusion Psychological, social and environmental may influence healthcare adherence among patients with NCDs during pandemics and should be focused on while devising future healthcare policy and interventions.

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High burden of non-adherence to blood pressure-lowering medications: meta-analysis of data from over 34,000 adults with hypertension in Sub-Saharan Africa

Aminde,

Agbor,

Fongwen

et al. 2024

Preprint

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Introduction: Non-adherence to blood pressure (BP)-lowering medication is a strong predictor of poor BP control. Sub-Saharan Africa (SSA) has extremely low BP control rates (~10%), but it is unclear what the burden of medication non-adherence among Africans with hypertension is. This systematic review estimated the prevalence and determinants of non-adherence to BP-lowering medications in SSA. Methods: Multiple databases were searched from inception to 6 December 2023. Two reviewers performed independent screening, extraction, and quality assessment of studies. We pooled the prevalence estimates using random effects meta-analyses and summarized the determinants using a narrative synthesis. Results: From the 1,307 records identified, we included 95 studies published between 1995 and 2023. The overall prevalence of non-adherence to BP-lowering medication among 34,102 people treated for hypertension in 27 countries was 43.5% (95% confidence interval 39.4 to 47.6; I2 = 98.3%). There was no change in the prevalence of non-adherence over time. The burden of non-adherence varied by measurement method (p = 0.028) and by median age (38.8%, > 57 years vs. 47.9%, ≤ 57 years; p = 0.015). Socioeconomic and patient-related factors were the most frequent factors that influenced medication adherence. Active patient participation in management, accurate perceptions, and knowledge of hypertension and its treatment predicted good medication adherence, whereas high pill burden, medication cost, side effects, and comorbidities predicted poor adherence. Conclusions: With the African population projected to increase from 1.4 to ~2.5 billion by 2050, targeted strategies are urgently needed to optimise medication adherence in people with hypertension in SSA.

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Antihypertensive Medication Adherence and Associated Factors: A Cross-Sectional Analysis of Patients Attending a National Referral Hospital in Asmara, Eritrea

Cited by 5 publications

References 32 publications

Predictors of non-adherence to antihypertensive medications: A cross-sectional study from a regional hospital in Afghanistan

Predictors of non-adherence to antihypertensive medications: A cross-sectional study from a regional hospital in Afghanistan

Quality of Life and Adherence to Healthcare Services During the COVID-19 Pandemic: A Cross-Sectional Analysis

High burden of non-adherence to blood pressure-lowering medications: meta-analysis of data from over 34,000 adults with hypertension in Sub-Saharan Africa

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