Abstract

BackgroundAdherence to antihypertensive medications is a key component to control blood pressure levels. Poor adherence to these medications leads to the development of hypertensive complications and increase risk of cardiovascular events which in turn reduces the ultimate clinical outcome. The purpose of this study was to assess antihypertensive medication adherence and associated factors among adult hypertensive patients. A hospital-based cross-sectional study among adult hypertensive patients was conducted at hypertensive follow-up clinic of Jimma University Specialized Hospital from March 4, 2015 to April 3, 2015. A simple random sampling technique was used to select the study participants from the study population. The study patients were interviewed and their medical charts were reviewed using a pretested structured questionnaire. Adherence was assessed using Morisky Medication Adherence Scale-8 (MMAS-8) and MMAS-8 score less than 6 was considered as non-adherent and MMAS-8 score was ≥ 6 was declared as adherence. Factors associated with adherence were identified using binary and multivariate logistic regression analysis. Crude odds ratio, adjusted odds ratio (AOR) and 95% confidence interval of the odds ratio were calculated using SPSS version 21. Variables with p-value less than 0.05 were assumed as statistically significant factors.ResultsAmong 280 hypertensive patients, 61.8% of the study participants were found to be adherent. More than half (53.2%) of the participants were males and the mean age of the participants was 55.0 ± 12.7 years. Co-morbidity (AOR = 0.083, 95% CI = 0.033–0.207, p < 0.001), alcohol intake (AOR = 0.011, 95% CI = 0.002–0.079, p < 0.001), getting medications freely (AOR = 0.020, 95% CI = 0.003–0.117, p < 0.001), and combination of antihypertensive medications (AOR = 0.32, 95% CI = 0.144–0.712, p < 0.005) were inversely associated with antihypertensive medication adherence.ConclusionThe adherence level to the prescribed antihypertensive medications was found to be sub-optimal according to the MMAS-8, and influenced by co morbidity, alcohol intake, self-purchasing of the medications and combination of antihypertensive medications.

Highlights

  • Adherence to antihypertensive medications is a key component to control blood pressure levels

  • The rate of blood pressure (BP) control varies from country to country in which the level of controlled BP among treated cases were 65, 50, 40, 32.8 and 30% in Bahrain, USA, England, Zimbabwe, and Germany respectively [5,6,7,8,9]

  • Adherence to antihypertensive medication therapy is the main predictor of treatment success and an effective step in controlling BP and preventing complications [14]

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Summary

Introduction

Adherence to antihypertensive medications is a key component to control blood pressure levels. Poor adherence to these medications leads to the development of hypertensive complications and increase risk of cardiovascular events which in turn reduces the ultimate clinical outcome. The purpose of this study was to assess antihypertensive medication adherence and associated factors among adult hypertensive patients. Hypertension is the most significant risk factor for cardiovascular disease and its prevalence is still increasing globally [1,2,3]. Effective antihypertensive treatment should be maintained indefinitely to reduce the relative risk of stroke and other cardiovascular disease events [13]. Due to the asymptomatic nature of the disease and indefinite treatment duration, medication adherence remains a significant challenge among these patients. Adherence to antihypertensive medication therapy is the main predictor of treatment success and an effective step in controlling BP and preventing complications [14]

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