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

Background Medication 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. Methods A 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. Results A 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. Conclusion A 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.

[1]  B. Tayo,et al.  Factors Associated with Medication Nonadherence among Hypertensives in Ghana and Nigeria , 2015, International journal of hypertension.

[2]  M. Petzold,et al.  Adherence to Antihypertensive Therapy and Elevated Blood Pressure: Should We Consider the Use of Multiple Medications? , 2015, PloS one.

[3]  G. Jean-Louis,et al.  Medication Routines and Adherence Among Hypertensive African Americans , 2015, Journal of clinical hypertension.

[4]  P. Kabra,et al.  FACTORS ASSOCIATED WITH ADHERENCE TO ANTIHYPERTENSIVE TREATMENT AMONG HYPERTENSIVE PERSONS IN A URBAN SLUM AREA OF HYDERABAD , 2015 .

[5]  Siraj Ahmad Assessment of adherence to antihypertensive treatment among patients attending a health care facility in North India , 2015 .

[6]  A. Adane,et al.  Prevalence and Associated Factors of Hypertension among Adults in Durame Town, Southern Ethiopia , 2014, PloS one.

[7]  S. Purdy,et al.  Determinants of blood pressure control in rural KwaZulu-Natal, South Africa , 2014 .

[8]  Mebratu Legesse Bekele,et al.  Antihypertensive medication non-adherence and its determinants among patients on follow up in public hospitals in Northern Ethiopia , 2014 .

[9]  Esayas Kebede Gudina,et al.  Prevalence of Hypertension and Associated Factors in Bedele Town, Southwest Ethiopia , 2014, Ethiopian journal of health sciences.

[10]  Esayas Kebede Gudina,et al.  Prevalence of hypertension and its risk factors in southwest Ethiopia: a hospital-based cross-sectional survey , 2013, Integrated blood pressure control.

[11]  F. Babiker,et al.  Awareness of hypertension and factors associated with uncontrolled hypertension in Sudanese adults , 2013, Cardiovascular journal of Africa.

[12]  C. Agyemang,et al.  Status report on hypertension in Africa - Consultative review for the 6th Session of the African Union Conference of Ministers of Health on NCD's , 2013, The Pan African medical journal.

[13]  H. A. Hareri,et al.  Assessments of Adherence to Hypertension Medications and Associated Factors among Patients Attending Tikur Anbessa Specialized Hospital Renal Unit, Addis Ababa, Ethiopia 2012 , 2013 .

[14]  B. Drame,et al.  Patients-related predictors of poor adherence to antihypertensive treatment in Congo-Brazzaville : a cross-sectional study , 2013 .

[15]  A. Adeoti,et al.  Adherence to Antihypertensive Medications and Some of Its Clinical Implications in Patients Seen At a Tertiary Hospital in Nigeria , 2013 .

[16]  T. Awoke,et al.  Prevalence and associated factors of hypertension among adults in Gondar, Northwest Ethiopia: a community based cross-sectional study , 2012, BMC Cardiovascular Disorders.

[17]  T. Paraidathathu,et al.  Medication adherence among hypertensive patients of primary health clinics in Malaysia , 2012, Patient preference and adherence.

[18]  A. Kengne,et al.  Peer Review History Title (provisional) Prevalence, Awareness, Treatment and Control of Hypertension in a Self-selected Sub-saharan African Urban Population: a Cross- Sectional Study , 2022 .

[19]  Z. Mengesha,et al.  Adherence to antihypertensive treatment and associated factors among patients on follow up at University of Gondar Hospital, Northwest Ethiopia , 2012, BMC Public Health.

[20]  M. Dimatteo,et al.  Improving the measurement of self-reported medication nonadherence: Final response , 2011 .

[21]  Graeme J. Hankey,et al.  Guide to management of hypertension 2008 - Assessing and managing raised blood pressure in adults , 2008 .

[22]  P. Davidson,et al.  A Patient Education Program to Improve Adherence Rates with Antituberculosis Drug Regimens , 1990, Health education quarterly.

[23]  L. Green,et al.  Concurrent and Predictive Validity of a Self-reported Measure of Medication Adherence , 1986, Medical care.

[24]  C. Dolea,et al.  World Health Organization , 1949, International Organization.