Antihypertensive medication non-adherence and predictors among adult patients on follow-up, Ethiopia: Prospective cross-sectional study

• Autores: Bezie Kebede, Mamo Magaze
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 22, Nº. 2, 2020, págs. 70-79
• Idioma: inglés
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• Resumen

  • Introduction: The overall burden of hypertension related diseases is rapidly rising in the developing world. A systematic review of prevalence and associated factors in Ethiopia indicates the prevalence of hypertension in Ethiopia ranges from 0.8-31.5%. Low antihypertensive medication adherence has been proposed as an important barrier to achieving hypertension control. Demographic, treatment, clinical and behavioral factors have been shown to be associated with medication non-adherence, and previous studies have indicated that psychosocial factors are important determinants of antihypertensive medication non-adherence in older adults. Objective: To assess the magnitude of non-adherence and predictors among adult hypertensive patients on follow-up in chronic follow-up, Mizan-Tepi University Teaching Hospital (MTUTH). Method: Institutional based cross-sectional study was conducted to assess the prevalence and predictors of non-adherence of all adult hypertensive patients that attended during study period from February 19 to April 5/2019. Structured interview questionnaire of data collection format and 8-item Morisky medication adherence scale was used and patient medication chart was reviewed. Data was entered to epi-data version 3.1 and analyzed using STATA version 14.2. Mean or median and standard deviation was used for continuous variable and chi-square test for ordinal and nominal variables. Independent predictors of outcome was identified and strength of association between dependent and independent variables determined by using by regression analysis. Before computing binary logistic regression analysis, presence of co-linearity between independent factor (having 1.5 variance inflation factor) and model fitness (with Hosmer lemeshow p-value 0.16) were checked. P-value less than 0.25 in binary logistic regression was entered to multivariate model and finally P-value of <0.05 was considered to declare statistical significance. Result: A total of 153 study participants were included in the study making the response rate of 98.7%. More than half of respondents were male 54.2%. The mean age of respondents was 46.85 years with a standard deviation of 11.7. Seventy two (47.06%, 95% CI: 45-57) respondents were non-adherent according to Morisky adherence scale. Lack of previous counseling/education (p = 0.021), educational status (p = 0.032), patient knowledge (p = 0.035), family support (p = 0.037), blood control status (p = 0.028) and patients cover their drug cost by themselves (p = 0.048) were factors that significantly associated with non-adherence. Conclusion and recommendation: The rate of non-adherence to antihypertensive medication is high and different factors can contribute to occur it. Government shall try to cover under the umbrella of health insurance to prevent medication non-adherence because of drug acquisition cost. Health care providers especially pharmacist should consider counseling integral part of patient management and give ample information about the negative impact of non-adherence on blood control status and post blood pressure complication. © 2020 Rasgo Editorial S.A.. All rights reserved.