Medication adherence and its associated factors among hypertensive patients attending the Debre Tabor General Hospital, northwest Ethiopia

Abstract

BackgroundMedication adherence is an important predictor of optimal blood pressure control; hence, it significantly reduces the risk of cardiovascular disease (CVD) and associated deaths. However, studies on medication adherence and its associated factors are scarce. Thus, this study aimed to assess adherence to antihypertensive medications and identify associated factors at Debre Tabor General Hospital, northwest Ethiopia.MethodsA hospital-based cross-sectional study was conducted. Simple random sampling technique was used to select 346 participants. A structured questionnaire adapted from the World Health Organization (WHO) STEPwise approach was used to collect data. Medication adherence was measured by the four-item Morisky–Green–Levine Scale, with a score ≥3 defined as “good adherence”. Data were entered using Epi Info version 7 and exported to SPSS version 20 for analysis. Descriptive and summary statistics were used. Bivariate and multivariable analyses were also carried out.ResultsA total of 337 hypertensive patients participated in the study. Three-quarters (75.1%) of the participants were found to be adherent to their medication therapy. The multivariable logistic regression analysis showed that urban residence (adjusted odd ratio [AOR]=2.10, 95% confidence interval [CI]: 1.15, 3.85), taking less than two drugs per day (AOR=3.04, 95% CI: 1.53, 6.06), and having knowledge about hypertension (HTN) and its treatment (AOR=8.86, 95% CI: 4.67, 16.82) were positively and significantly associated with medication adherence, while age >60 years (AOR=0.33, 95% CI: 0.11, 0.98) was negatively and significantly associated with good medication adherence.ConclusionA significant proportion of hypertensive patients poorly adhere to antihypertensive medications. Age, residence, pill burden, and knowledge about HTN and its treatment are important predictors of medication adherence. Attention should be given to increase the knowledge of patients about their disease and its treatment, and due emphasis should also be given to older and rural patients.

Determinants of adherence to anti-hypertensive medications among adult hypertensive patients on follow-up in Hawassa Referral Hospital: A case–control study

“…[23][24][25][26] In this study, patients with age <44 years old were three times more likely adherent than elderly patients. According to some reports in line with this study, younger patients showed better adherence to pharmacological treatment, 27 while others stated that young age is a determinant of poorer adherence to hypertensive medication. 12,25,26 Non-adherence in younger patients might be due to the lack of symptoms at early stages of the illness or more concerns about medication side effects.…”

<p>Magnitude and Determinants of Uncontrolled Blood Pressure Among Adult Hypertensive Patients on Follow-Up at Nekemte Referral Hospital, Western Ethiopia</p>

“…1,[5][6][7][8] It is one of the major, prevalent but modifiable risk factors, especially among patients with established cardiovascular disease (CVD) and cerebrovascular accidents. 2,9,10 As a result, HTN is the leading cause of morbidity and mortality among non-communicable diseases [11][12][13][14][15] and ranks third as a cause of disability-adjusted life-year causing about 7.1 million premature deaths each year. 11 Additionally, the complications of HTN account for 9.4 million deaths worldwide every year.…”

“…6,21 Even the prevalence of HTN has been increasing at an alarming rate among developing nations, especially in the African region. 15,22 The prevalence of HTN in Sub-Saharan Africa (SSA) has attained epidemic proportions likely due to the epidemiological transition and lifestyle modification with the adoption of western lifestyles. 23,24 In SSA, an estimated 74.7 million individuals are hypertensive and by the year 2025, the number of hypertensive individuals is projected to increase by 68% to 125.5 million individuals.…”

“…3 Controlling BP is needed to reduce the morbidity and mortality of CVD. 10,15,22 Even the complications of HTN can be delayed with good BP control. 22 Several lifestyle interventions have been shown to reduce BP.…”

Level of medication self-management capacity among patients on ambulatory care exiting hospital pharmacy at Muhimbili National hospital, Tanzania: a descriptive cross-sectional study

“…Therefore, tough the study didn't focus on associated factors; it is most probable that education level of the study participants had a major influence of MMC as it was reported in study by Kripalani et al [6] and in the study which was conducted in Ethopia [13].…”