Antihypertensive medications adherence and associated uncontrolled blood pressure among hypertensive patients in Ethiopia: Systematic review and meta-analysis

Yibeltal, Desalegn; Memiah, Peter; Ayenew, Temesgen; Mulugeta, Henok; Gedefaw, Mihretie; Kidanie, Bekalu Bewket; Birhanu, Molla Yigzaw; Tessema, Zenaw; Mengist, Belayneh; Alene, Muluneh; Simieneh, Muluye Molla; Alle, Atsede; Shiferaw, Wondimeneh Shibabaw; Yeshitila, Yordanos Gizachew

doi:10.1016/j.ijans.2022.100404

Cited by 5 publications

(6 citation statements)

References 55 publications

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“…Blood pressure control is found to be associated with adherence. Similar findings were reported from several studies demonstrating the strong association between antihypertensive drug adherence and blood pressure control [24, 46–49].…”

Section: Discussionsupporting

confidence: 91%

“…In this study, the rate of antihypertensive drug adherence was 72.5%, which is higher than other studies conducted in Dessie Referral Hospital (51.9%) [20], Jimma University Medical Center (61.8%) [21], Southwest Ethiopia (60.5%) [22], Nedjo General Hospital (31.4%) [23], and the national medication adherence rate among hypertensive patients (65.1%) [24]. However, the rate of medication adherence was comparable with a study conducted in Sudan, which is 70.5% [25] and lower compared with a study from Tanzania, where the adherence rate was 76.9%, and a study in Japan reported an adherence rate of 91.5% [26].…”

Section: Discussioncontrasting

confidence: 70%

“…Opposite results were reported from various studies in which the presence of chronic kidney disease was associated with poor drug adherence and the adherence rate also declined with worsening CKD [38, 39, 40]. Of note, a Brazilian study has shown that drug adherence tends to improve as renal function deteriorates [ 41] and another systematic review and meta-analysis showed a 2.54 times increase in the odds of being adherent among patients who had co-morbidities as compared with those without comorbidities [24].…”

Section: Discussionmentioning

confidence: 99%

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

Elias,

Minyilshewa,

Tekle

et al. 2024

Preprint

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Background: Hypertension or elevated blood pressure is a serious medical condition that significantly increases the risk of diseases of the heart, brain, kidneys, and other organs. Antihypertensive drug adherence is a key to controlling blood pressure. Objective: To assess factors associated with antihypertensive drug adherence and blood pressure control among hypertensive patients in Selected Public Hospitals under Addis Ababa City Administration. Method: A hospital-based cross-sectional study was conducted among hypertensive patients on follow-up in randomly selected Public Hospitals under the Addis Ababa City Administration from May 1, 2022, to August 31, 2022. The study population was 393 and patients who fulfilled the eligibility criteria were selected by systematic random sampling and the first participant was selected randomly. Data collection was conducted by reviewing the patients electronic medical records and by interviewing patients with a structured questionnaire. Data was entered into Epi-Info 7.2.1 and exported to SPSS version 25 software for analysis. Logistic regression analysis was done to see the association between the dependent and independent variables. Result: The rate of antihypertensive drug adherence and blood pressure control was 72.5 % and 23.4% respectively. Participants with uncontrolled blood pressure were found to be 41.7% less adherent than those with controlled blood pressure (AOR= 0.59; 95% CI, 0.36-0.97). Non-adherence to dietary restriction (AOR, 3.31; 95% CI, 1.84-5.96) and chronic kidney disease (AOR=3.85; 95% CI, 1.41-10.52) are associated with good adherence, whereas using single antihypertensive drug (AOR=0.53; 95% CI, 0.30–0.94), and non–adherence to moderate physical exercise (AOR=0.30; 95% CI, 0.20–0.65) were associated with poor adherence to antihypertensive medications. Male sex (AOR=1.95; 95% CI, 1.04-3.28) and blood pressure measurement at home (AOR=0.59; 95% CI, 0.36–0.99) were independent predictors of controlled blood pressure. Drinking alcohol (AOR=1.92; 95% CI, 1.05–3.49) is inversely associated with blood pressure control. Conclusion: Despite good adherence to antihypertensive medications, blood pressure control was low. This signifies the importance of lifestyle measures beyond pharmacologic intervention.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

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

Elias,

Minyilshewa,

Tekle

et al. 2024

Preprint

View full text Add to dashboard Cite

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“…Obstacles are one of the patient-related factors which have a negative effect on adherence to medication. A number of the relevant studies have confirmed this issue [49,52]. The obstacles, which exist in reality or in the patients’ minds, prevent the patients from adhering to drug treatment and decrease their adherence to drug treatment.…”

Section: Discussionmentioning

confidence: 99%

“…The results of the other studies, which have been conducted in other parts of the world, were not in line with the results of our study. More specifically, these studies have highlighted the fact that the patients' adherence to drug treatment was satisfactory [48,49]. In general, international studies have reported that adherence to antihypertensive drugs is usually 50% and less than 50% in developing countries [4,50].…”

Section: Discussionmentioning

confidence: 99%

Factors related to medication adherence in patients with hypertension in Iran: a systematic review study

Maleki,

Norian,

Moeini

et al. 2023

Blood Pressure Monitoring

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Objectives This study aimed to review the available studies of the factors in Iranian hypertensive patients’ adherence to drug treatment. Methods Four Persian databases and seven English databases were searched. The articles, which were published from 2000 to 2022 in Persian and English and examined the adherence to drug treatment in the Iranian population of adults with high blood pressure, were reviewed. Based on the primary examination, 31 of the initial 1062 articles met the inclusion criteria and were included in the analysis. The evidence, which was provided by the examined articles, was summarized and discussed using the 5-dimensional framework of adherence to long-term treatments, which was developed by WHO. Results The factors that significantly correlated with adherence to drug treatment in the examined studies were: (1) factors that were related to the health team or the health system: patients’ satisfaction with their doctor-patient relationship; (2) factors that were related to the conditions: the number of concomitant diseases, high quality of life and the implementation of effective interventions; (3) factors which were related to the treatment: long duration of illness, short intervals between the visits, duration of treatment, lower numbers of drugs, and the patient’s blood pressure control; and (4) factors that were related to the patient: self-efficacy, health literacy, social support, locus of control, illness perception, beliefs, attitude, knowledge, and cues to action. Conclusion: It is possible to draw definite conclusions about the factors which affect adherence to drug treatment in patients with high blood pressure because most of the relevant studies have been cross-sectional. Therefore, in the future, valuable results can be obtained by conducting more studies that preferably use objective instruments for assessing adherence to drug treatment

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Determinants of medication adherence among elderly with high blood pressure living in deprived areas

Afshari,

Karimi-Shahanjarini,

Tapak

et al. 2024

Chronic Illness

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Introduction The current study was conducted to determine the impact of health literacy and factors related to adherence to drug treatment, using the model proposed by the World Health Organization, in older adults with hypertension residing in informal settlements in Hamadan. Methods This cross-sectional study was conducted on 405 patients in Hamadan city, located in the western part of Iran. Data were collected using an interviewer-administered questionnaire that included the 5-dimensional model proposed by the World Health Organization, Health Literacy for Iranian Adults, and Morisky Medication Adherence Scale-8. A two-stage sampling procedure was used to select patients from 14 comprehensive health service centers and health bases. The data were analyzed using SPSS v.24. Results The study found that medication adherence was suboptimal in 63% of the participants. Additionally, 87.5% of patients had inadequate or insufficient health literacy. Factors related to medication adherence included age (odds ratio (OR) = 1.07), annual income (OR = 0.17), duration of hypertension (OR = 7.33), health literacy (OR = 1.03), self-reported health status (P < 0.05), and regular medication use (P < 0.008). Conclusion The results of this study indicate that more than half of the older adults in the study had suboptimal medication adherence and insufficient health literacy. The study also found that various factors, such as socioeconomic status, disease and treatment-related factors, and patient-related factors, influence medication adherence among older adults.

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Antihypertensive medications adherence and associated uncontrolled blood pressure among hypertensive patients in Ethiopia: Systematic review and meta-analysis

Cited by 5 publications

References 55 publications

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

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

Factors related to medication adherence in patients with hypertension in Iran: a systematic review study

Determinants of medication adherence among elderly with high blood pressure living in deprived areas

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