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Virginia Hernández Corredoira
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Volume 22 - Issue 2, April-June 2020
ORIGINAL
ANTIHYPERTENSIVE MEDICATION NON-ADHERENCE AND PREDICTORS AMONG ADULT PATIENTS ON FOLLOW-UP, ETHIOPIA: PROSPECTIVE CROSSSECTIONAL STUDY
KEBEDE BEZIE, MAGAZE MAMO


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 im- portant barrier to achieving hypertension control.
Demographic, treatment, clinical and behavioral factors have been shown to be associated with
medication non-ad- herence, 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 Uni- versity 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 inter- view questionnaire of data collection format
and 8-item Morisky medication adher- ence 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 or- dinal 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 analy- sis, presence of co-linearity between independent factor (having
1.5 variance infla- tion 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 antihyperten- sive medication is high
and different factors can contribute to occur it. Govern- ment shall try to cover under the
umbrella of health insurance to prevent med- ication non-adherence because of drug acquisition
cost. Health care providers especially pharmacist should consider counseling integral part of
patient manage- ment and give ample information about the negative impact of non-adherence on blood
control status and post blood pressure complication.

DETERMINANTS – HYPERTENSION – NON-ADHERENCE – OUTPATIENT



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