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Antihypertensive medication adherence and associated factors among adult hypertensive patients at Jimma University Specialized Hospital, southwest Ethiopia.

ABSTRACT: 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. 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.Among 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.The 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.

SUBMITTER: Asgedom SW

PROVIDER: S-EPMC5769214 | biostudies-other | 2018 Jan

REPOSITORIES: biostudies-other

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Antihypertensive medication adherence and associated factors among adult hypertensive patients at Jimma University Specialized Hospital, southwest Ethiopia.

Asgedom Solomon Weldegebreal SW Atey Tesfay Mehari TM Desse Tigestu Alemu TA

BMC research notes 20180115 1

<h4>Background</h4>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. A hospital-based cross-sectional study among adult hypertensive ...[more]

PMID: 29335003

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Project description:BACKGROUND:Drug therapy problem (DTP) is any unwanted incident related to medication therapy that actually or potentially affects the desired goals of treatment. Heart failure (HF) patients are more likely to experience DTP owing to multiple prescriptions and comorbidities. Despite the serious negative impact of DTP on treatment outcomes, there is a dearth of study on DTP among HF patients in Ethiopia. OBJECTIVE:The main aim of this study was to assess the prevalence and contributing factors of DTP among ambulatory HF patients in Jimma University Specialized Hospital, Ethiopia. METHODS:A hospital based prospective observational study was conducted. Written informed consent was obtained from each patient after full explanation of the study. Data were collected through patient interview and expert review of medical, medication and laboratory records of one-year follow-up from May 2015 to April 2016. DTPs were identified using Cipolle's method followed by consensus review with experts. Binary logistic regression was performed to identify factors contributing to DTP. A p<0.05 was considered statistically significant in all analyses. RESULT:Of 340 study participants; male to female ratio was equivalent, the mean (± SD = standard deviation) age was 50.5±15.6 years. Eight hundred eighty DTPs were identified equating 2.6 ±1.8 DTPs per patient. The frequently identified DTPs were dosage too low (27.8%), ineffective drug therapy (27.6%) and need additional drug therapy (27.4%). Most commonly implicated drugs were beta-blockers (34.4%), angiotensin converting enzyme inhibitors (24.8%), statins (16.5%) and antithrombotics (13.1%). Factors contributing to DTP were age >50 years (AOR [adjusted odd ratio] = 5.43, 95%CI [95% confidence interval] = 2.03-14.50); negative medication belief (AOR = 3.50, 95%CI = 1.22-10.05); poor involvement of patients in the therapeutic decision makings (AOR = 4.11, 95%CI = 1.91-8.88); number of co-morbidity?2(AOR = 5.26, 95%CI = 2.38-11.65) and number of medications ?5 (AOR = 3.68, 95%CI = 1.28-10.51). CONCLUSION:DTPs are common among ambulatory care HF patients. Patients with older age, negative medication belief, polypharmacy, co-morbidities and those who were poorly involved in the therapeutic decision were more likely to experience DTP. Despite traditional prescription refilling, an integrated multidisciplinary approach involving patients and clinically trained pharmacists should be implemented in the patient care process at ambulatory care clinics in order to improve overall outcomes and reduce DTPs and associated burdens in HF patients.

Project description:Data regarding the prevalence of metabolic syndrome (MetS) among hypertensive patients in Ethiopia is very scarce, and the nature and the burden of MetS among these patients has not been well investigated. Therefore, the aim of this study was to assess the pattern and risk factors of MetS in hypertensive patients.A cross-sectional study was conducted at Hawassa University comprehensive specialized hospital from September 2015 to June 2016. Data on socio-demographic, clinical and anthropometric characteristics were collected from 238 hypertensive participants using WHO stepwise technique. Blood glucose and lipid profiles were determined after overnight fasting. Finally, MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III Criteria.The overall prevalence of MetS was 48.7% and urban dwellers had significantly higher prevalence of MetS (82.8%) compared to rural inhabitants (17.2%), p = 0.003. About 37.8%, 62.2%, 60.9% and 35.7% of the participants had abdominal obesity, elevated triglycerides, low HDL-c, and increased fasting blood glucose, respectively. In addition the mean HDL-c was significantly lower in MetS group compared to non-MetS group (39.4 vs.47.6), P < 0.0001. Age over 60 years, overweight, and obesity were associated risk factors of MetS. The adjusted odds ratio (95% CI) was 8.2 (1.1-62.4) for age over 60 years, 2.8 (1.4-5.9) for overweight and 10.7 (3.8-29.8) for obesity. Moreover monthly income of 1001-2000 Ethiopian birr, income ≥2001birr, a retirement pension, being married, divorced/widowed were also significantly associated risk factors of MetS, the adjusted odds ratio (95% CI) was 3.6 (1.1-12.5), 5.8 (1.5-22.3),5.3 (1.1-25.9),7.2 (1.4-35.9) and 16.4 (1.1-244.2), respectively.Metabolic syndrome is highly prevalent among hypertensive patients and this may potentiate the risk of cardiovascular problems. Therefore, regular screening of patients for individual components of MetS is vital in order to avert/limit the risks before developing cardiovascular related morbidity and mortality.

Project description:Background: Hypertension is a significant cardiovascular disease (CVD) and driver to CVD disorders in sub-Saharan Africa. It is a major independent risk factor for heart failure, stroke, and kidney failure. Persons living with hypertension attend to many aspects of self-care to manage their condition, including high blood pressure medication adherence to control of blood pressure. Rates of medication non-adherence, and thus uncontrolled hypertension, remain high and contribute to poor health outcomes. Understanding barriers and facilitators to adherence to hypertension therapies can help improve health outcomes. Objective: The aim of the study was to describe the common reasons for adherence and non-adherence to antihypertensive medication from patients’ perspectives. Methods: A qualitative study engaged clients of an out-patient clinic of a regional referral hospital in southwestern Uganda who were living with hypertension as participants. One-on-one in-depth interviews provided the narrative data. The interview transcripts were analyzed using thematic analysis. Findings: Sixteen participants provided the data for the findings. The themes identified as facilitators for adherence to antihypertensive medication were patients’ understanding of prescribed medication, availability of medication for hypertension, family support for patients living with hypertension, and regular review appointments at the hypertensive clinics. Conversely, lack of supply in government dispensaries, use of self-prescribed analgesic medication, and stigma were identified as barriers and challenges of adherence to antihypertensive medication. Conclusions: There is an urgent need for the health ministry to improve availability of high blood pressure medication and for health care providers to deliver individualized patient centered care, and sensitization on danger of self-prescription and measures that reduce stigma. These strategies may improve adherence to high blood pressure medication.

Project description:BackgroundMany studies conducted in the past focused on patients' sociodemographic factors and medical profiles to identify the determinants of suboptimal blood pressure control. However, prescribing patterns and clinicians' adherence to guidelines are also important factors affecting the rate of blood pressure control. Therefore, this study aimed to determine clinicians' prescribing patterns, patients' medication adherence, and its determinants among hypertensive patients at Jimma University Medical Center.MethodsA general prospective cohort study was conducted among hypertensive patients who had regular follow-up at Jimma university ambulatory cardiac clinic from March 20, 2018, to June 20, 2018. Patients' specific data was collected with a face-to-face interview and from their medical charts. Clinicians' related data were collected through a self-administered questionnaire. Data were analyzed using SPSS version 21.0. Bivariate and multivariable logistic regression analyses were done to identify key independent variables influencing patients' adherence. P-Values of less than 0.05 were considered statically significant.ResultsFrom the total of 416 patients, 237(57.0%) of them were males with a mean age of 56.50 ± 11.96 years. Angiotensin-converting enzyme inhibitors were the most frequently prescribed class of antihypertensives, accounting for 261(63.7%) prescriptions. Combination therapy was used by the majority of patients, with 275 (66.1%) patients receiving two or more antihypertensive drugs. Patients' medication adherence was 46.6%, while clinicians' guideline adherence was 44.2%. Patients with merchant occupation (P = 0.020), physical inactivity (P = 0.033), and diabetes mellitus co-morbidity (P = 0.008) were significantly associated with a higher rate of medication non-adherence.ConclusionThe rate of medication adherence was poor among hypertensive patients. Physicians were not-adherent to standard treatment guideline. The most commonly prescribed class of drugs were angiotensin-converting enzyme inhibitors. Effective education should be given to patients to improve medication adherence. Prescribers should be trained on treatment guidelines regularly to keep them up-to-date with current trends of hypertension treatment and for better treatment outcomes.

Project description:BackgroundEssential hypertension is a condition characterized by a rise in blood pressure of undetermined cause, includes 90% of all hypertensive cases and is a highly important public health challenge with major modifiable cause of morbidity and mortality. Uric acids disorders in particular hyperuricemia are significant problems in essential hypertensive patients and can cause substantial morbidity and mortality. Determination of uric acid disorders may play a major role in the management and early aversion of complications in hypertensive patient. Therefore, this study aimed to determine uric acid disorders and associated factors among essential hypertensive adults in the outpatient department at Wolkite University specialized Hospital, Southern Ethiopia from November 1 to February 30, 2021.Methods and materialsAn institional based cross sectional study was conducted on 270 essential hypertensive adults on follow-up in outpatient department from November 1 to February 30, 2021. Structured questionnaires through face to face interviews and participants' medical records were used to collect information on determinants related with uric acid disorders. The blood specimen was collected and level of serum uric acid, blood sugar and lipid profile was measured using standard principles and procedures with an ABX Pentra 400 automated chemistry analyzer. Bivariate and multivariate logistic regression analyses were done to identify factors associated with hyperuricemia. The p-value was set at <0.05 with a 95% confidence interval of the adjusted odds ratio.ResultsA total of 270 adult essential hypertensive patients were participated in the study, among those 196(27.4%) of study participants were hyperuricemic with 95%CI (21.9, 33.3). Being alcoholic [(AOR: 15.68, 95% CI: (5.93, 21.41)], taking antihypertensive medication [(AOR: 11.56, 95% CI: (3.94, 23.80)], BMI > = 30 [(AOR: 4.89, 95% CI: (1.46, 25.5)] and being centrally obese [(AOR: 6.87, 95% CI: (2.53, 18.63)] were factors significantly associated with hyperuricemia.ConclusionIn this study, the high burden of hyperuricemia (27.4%) was observed in essential hypertensive patients with follow-up in outpatient department. Taking alcohol and antihypertensive medication, being overweight and centrally obese were identified factors of uric acid disorders. The finding of this study should be taken into consideration to implement preventive interventions on identified predictors in hypertensive patients. Taking fruit and vegetable, and promoting physical exercise and determinations of serum uric acid level in adult essential hypertensive patients was recommended to minimize the emergence of hyperuricemia.

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Antihypertensive medication adherence and associated factors among adult hypertensive patients at Jimma University Specialized Hospital, southwest Ethiopia.

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Antihypertensive medication adherence and associated factors among adult hypertensive patients at Jimma University Specialized Hospital, southwest Ethiopia.

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