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Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Adherence to antihypertensive treatment and associated factors among patients on follow up at University of Gondar Hospital, Northwest Ethiopia

Authors: Abere Dessie Ambaw, Getahun Asres Alemie, Solomon Meseret W/Yohannes, Zelalem Birhanu Mengesha

Published in: BMC Public Health | Issue 1/2012

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Abstract

Background

Hypertension is an overwhelming global challenge with high morbidity and mortality rates. The prevalence of HTN is estimated to be 6% in Ethiopia and 30% in Addis Ababa. Poor adherence is associated with bad outcome of the disease and wastage of healthcare resources. In Ethiopia, particularly in the study area little is known about treatment adherence and associated factors. Therefore this study aimed to assess adherence to antihypertensive therapy and associated factors among HTN patients on follow up at University of Gondar Referral Hospital.

Method

Institution based cross sectional study was conducted. Systematic sampling technique was used to select 384 participants. A structured standard questionnaire was used after some modifications. Morisky Medication Adherence Scale was used for labeling patients as adherent or non-adherent. Data were entered and analyzed using SPSS version 16.

Results

More than half (64.6 %) of the study participants were found to be adherent to their treatment. Sex (AOR = 0.48, 95%CI = 0.28, 0.82), knowledge about HTN and its treatment (AOR = 6.21, 95%CI = 3.22, 11.97), distance from the hospital (AOR = 2.02, 95% CI =1.19-3.43) and co morbidity (AOR = 2.5, 95%CI = 1.01, 6.21) variables were found significantly associated with treatment adherence.

Conclusion

Only 64.6% of the study subjects were found to be adherent to their treatment. Factors such as sex, distance from the hospital, number of co morbidities, Knowledge about HTN and its treatment were associated with adherence behavior of patients. Early diagnosis and management of co morbidities, adherence counseling and patient education about the disease and its treatment are important to improve adherence status of patients.
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Literature
1.
go back to reference Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J: Global burden of hypertension: analysis of worldwide data. Lancet. 2005, 365 (9455): 217-223.CrossRefPubMed Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J: Global burden of hypertension: analysis of worldwide data. Lancet. 2005, 365 (9455): 217-223.CrossRefPubMed
2.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL: Jones DW, Materson BJ, Oparil S, Wright JT Jr, et al: Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003, 42 (6): 1206-1252. 10.1161/01.HYP.0000107251.49515.c2.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL: Jones DW, Materson BJ, Oparil S, Wright JT Jr, et al: Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003, 42 (6): 1206-1252. 10.1161/01.HYP.0000107251.49515.c2.CrossRefPubMed
3.
go back to reference Hajjar I, Kotchen TA: Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA. 2003, 290 (2): 199-206. 10.1001/jama.290.2.199.CrossRefPubMed Hajjar I, Kotchen TA: Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA. 2003, 290 (2): 199-206. 10.1001/jama.290.2.199.CrossRefPubMed
4.
go back to reference Salako LA: Hypertension in Africa and Effectiveness of Its Management with Various Classes of Antihypertensive Drugs and in Different Socio-Economic and Cultural Environments. Clin Exp Hypertens. 1993, 15 (6): 997-1004. 10.3109/10641969309037087.CrossRefPubMed Salako LA: Hypertension in Africa and Effectiveness of Its Management with Various Classes of Antihypertensive Drugs and in Different Socio-Economic and Cultural Environments. Clin Exp Hypertens. 1993, 15 (6): 997-1004. 10.3109/10641969309037087.CrossRefPubMed
5.
go back to reference Tesfaye F, Byass P, Wall S: Population based prevalence of high blood pressure among adults in Addis Ababa: uncovering a silent epidemic. BMC Cardiovasc Disord. 2009, 9: 39-10.1186/1471-2261-9-39.CrossRefPubMedPubMedCentral Tesfaye F, Byass P, Wall S: Population based prevalence of high blood pressure among adults in Addis Ababa: uncovering a silent epidemic. BMC Cardiovasc Disord. 2009, 9: 39-10.1186/1471-2261-9-39.CrossRefPubMedPubMedCentral
6.
go back to reference Ong KL, Cheung BMY, Man YB, Lau CP, Lam KSL: Prevalence, Awareness, Treatment, and Control of Hypertension Among United States Adults 1999–2004. Hypertension. 2006, 49: 69-75. 10.1161/01.HYP.0000252676.46043.18.CrossRefPubMed Ong KL, Cheung BMY, Man YB, Lau CP, Lam KSL: Prevalence, Awareness, Treatment, and Control of Hypertension Among United States Adults 1999–2004. Hypertension. 2006, 49: 69-75. 10.1161/01.HYP.0000252676.46043.18.CrossRefPubMed
7.
go back to reference Primatesta P, Poulter NR: Improvement in hypertension management in England: results from the Health Survey for England 2003. J Hypertens. 2006, 24 (6): 1187-1192. 10.1097/01.hjh.0000226210.95936.bc.CrossRefPubMed Primatesta P, Poulter NR: Improvement in hypertension management in England: results from the Health Survey for England 2003. J Hypertens. 2006, 24 (6): 1187-1192. 10.1097/01.hjh.0000226210.95936.bc.CrossRefPubMed
8.
go back to reference Hashmi SK, Afridi MB, Abbas K, Sajwani RA, Saleheen D, Frossard PM, Ishaq M, Ambreen A, Ahmad U: Factors associated with adherence to anti-hypertensive treatment in Pakistan. PLoS One. 2007, 2 (3): e280-10.1371/journal.pone.0000280.CrossRefPubMedPubMedCentral Hashmi SK, Afridi MB, Abbas K, Sajwani RA, Saleheen D, Frossard PM, Ishaq M, Ambreen A, Ahmad U: Factors associated with adherence to anti-hypertensive treatment in Pakistan. PLoS One. 2007, 2 (3): e280-10.1371/journal.pone.0000280.CrossRefPubMedPubMedCentral
9.
go back to reference Balkrishnan R: The importance of medication adherence in improving chronic-disease related outcomes: what we know and what we need to further know. Med Care. 2005, 43 (6): 517-520. 10.1097/01.mlr.0000166617.68751.5f.CrossRefPubMed Balkrishnan R: The importance of medication adherence in improving chronic-disease related outcomes: what we know and what we need to further know. Med Care. 2005, 43 (6): 517-520. 10.1097/01.mlr.0000166617.68751.5f.CrossRefPubMed
10.
go back to reference Morisky DE, Green LW, Levine DM: Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986, 24 (1): 67-74. 10.1097/00005650-198601000-00007.CrossRefPubMed Morisky DE, Green LW, Levine DM: Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986, 24 (1): 67-74. 10.1097/00005650-198601000-00007.CrossRefPubMed
11.
go back to reference Pratt RJ, Robinson N, Loveday HP, Pellowe CM, Franks PJ, Hankins M, Loveday C: Adherence to Antiretroviral Therapy: Appropriate Use of Self-Reporting in Clinical Practice. HIV Clin Trials. 2001, 2 (2): 146-159. 10.1310/89E2-XNJL-W107-R2GL.CrossRefPubMed Pratt RJ, Robinson N, Loveday HP, Pellowe CM, Franks PJ, Hankins M, Loveday C: Adherence to Antiretroviral Therapy: Appropriate Use of Self-Reporting in Clinical Practice. HIV Clin Trials. 2001, 2 (2): 146-159. 10.1310/89E2-XNJL-W107-R2GL.CrossRefPubMed
12.
go back to reference Inkster ME, Donnan PT, MacDonald TM, Sullivan FM, Fahey T: Adherence to antihypertensive medication and association with patient and practice factors. J Hum Hypertens. 2006, 20 (4): 295-297. 10.1038/sj.jhh.1001981.CrossRefPubMed Inkster ME, Donnan PT, MacDonald TM, Sullivan FM, Fahey T: Adherence to antihypertensive medication and association with patient and practice factors. J Hum Hypertens. 2006, 20 (4): 295-297. 10.1038/sj.jhh.1001981.CrossRefPubMed
13.
go back to reference Kearney PM, Whelton M, Reynolds K, Whelton PK, He J: Worldwide prevalence of hypertension: a systematic review. J Hypertens. 2004, 22 (1): 11-19. 10.1097/00004872-200401000-00003.CrossRefPubMed Kearney PM, Whelton M, Reynolds K, Whelton PK, He J: Worldwide prevalence of hypertension: a systematic review. J Hypertens. 2004, 22 (1): 11-19. 10.1097/00004872-200401000-00003.CrossRefPubMed
14.
go back to reference van der Sande MA, Milligan PJ, Nyan OA, Rowley JT, Banya WA, Ceesay SM, Dolmans WM, Thien T, McAdam KP, Walraven GE: Blood pressure patterns and cardiovascular risk factors in rural and urban gambian communities. J Hum Hypertens. 2000, 14 (8): 489-496. 10.1038/sj.jhh.1001050.CrossRefPubMed van der Sande MA, Milligan PJ, Nyan OA, Rowley JT, Banya WA, Ceesay SM, Dolmans WM, Thien T, McAdam KP, Walraven GE: Blood pressure patterns and cardiovascular risk factors in rural and urban gambian communities. J Hum Hypertens. 2000, 14 (8): 489-496. 10.1038/sj.jhh.1001050.CrossRefPubMed
15.
go back to reference Lennon C, Hughes CM, Mcelnay JC, Johnston GD: Identification of psychosocial factors which influence patient adherence with antihypertensive medication. Int J Pharm Pract. 2001, 9 (s1): 8-10.1111/j.2042-7174.2001.tb01068.x.CrossRef Lennon C, Hughes CM, Mcelnay JC, Johnston GD: Identification of psychosocial factors which influence patient adherence with antihypertensive medication. Int J Pharm Pract. 2001, 9 (s1): 8-10.1111/j.2042-7174.2001.tb01068.x.CrossRef
16.
go back to reference Rm Y: II M: Patterns and determinants of treatment compliance among hypertensive patients. East Mediterr Health J. 2002, 8 (4–5): 579-592. Rm Y: II M: Patterns and determinants of treatment compliance among hypertensive patients. East Mediterr Health J. 2002, 8 (4–5): 579-592.
17.
go back to reference Baune B, Aljeesh Y: The association of psychological stress and health related quality of life among patients with stroke and hypertension in Gaza Strip. Ann Gen Psychiatr. 2006, 5: 6-10.1186/1744-859X-5-6.CrossRef Baune B, Aljeesh Y: The association of psychological stress and health related quality of life among patients with stroke and hypertension in Gaza Strip. Ann Gen Psychiatr. 2006, 5: 6-10.1186/1744-859X-5-6.CrossRef
18.
go back to reference Krousel-Wood M, Thomas S, Muntner P, Morisky D: Medication adherence: a key factor in achieving blood pressure control and good clinical outcomes in hypertensive patients. Curr Opin Cardiol. 2004, 19 (4): 357-362. 10.1097/01.hco.0000126978.03828.9e.CrossRefPubMed Krousel-Wood M, Thomas S, Muntner P, Morisky D: Medication adherence: a key factor in achieving blood pressure control and good clinical outcomes in hypertensive patients. Curr Opin Cardiol. 2004, 19 (4): 357-362. 10.1097/01.hco.0000126978.03828.9e.CrossRefPubMed
19.
go back to reference Yiannakopoulou E, Papadopulos JS, Cokkinos DV, Mountokalakis TD: Adherence to antihypertensive treatment: a critical factor for blood pressure control. Eur J Cardiovasc Prev Rehabil. 2005, 12 (3): 243-249.CrossRefPubMed Yiannakopoulou E, Papadopulos JS, Cokkinos DV, Mountokalakis TD: Adherence to antihypertensive treatment: a critical factor for blood pressure control. Eur J Cardiovasc Prev Rehabil. 2005, 12 (3): 243-249.CrossRefPubMed
Metadata
Title
Adherence to antihypertensive treatment and associated factors among patients on follow up at University of Gondar Hospital, Northwest Ethiopia
Authors
Abere Dessie Ambaw
Getahun Asres Alemie
Solomon Meseret W/Yohannes
Zelalem Birhanu Mengesha
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-282

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