Journal de l'hypertension : accès libre

Compliance with Anti-Hypertensive Treatment and Associated Factors among Hypertensive Patients on Follow-Up in Jimma University Specialized Hospital, Jimma, South West Ethiopia: A Quantitative Cross- Sectional Study

Abstract

Fiseha Girma, Solomon Emishaw, Fessehaye Alemseged and Altayework Mekonnen

Objectives: Various explanations have been proffered to explain why a large percentage of patients have resistant hypertension, including secondary hypertension and endogenous resistance to treatment. However, the main reason for inadequate control of BP is poor compliance with the treatment regimen; both pharmacological and behavioral (e.g. weight reduction, sodium intake restriction, and exercise). Understanding the reasons for patient noncompliance with antihypertensive treatment is essential if BP is to be more effectively managed. The finding of this study will assist health care professionals to understand factors related to treatment compliance this enables them to manage hypertension appropriately both with medication and advising lifestyle interventions, also this study will be helpful to implement effective strategies that would lead to improved compliance, increased levels of controlled blood pressure and reduced occurrences of complications.

Background: Hypertension is defined as a systolic blood pressure greater than 140 mmHg and a diastolic blood pressure greater than 90 mmHg over a sustained period, based on the average of two or more blood pressure measurements taken in two or more contacts with the health care provider after an initial screening. Uncontrolled high blood pressure increases the risk of ischemic heart disease 3- to 4-fold, and the overall risk of cardiovascular disease 2- to 3-fold. Treatment of hypertension is multifaceted, requiring long-term compliance with both medication regimens and behavior modifications. Multiple factors contribute to the poor level of compliance with long-term antihypertensive therapy.The aim of this study is to assess the factors affecting compliance with antihypertensive treatment among hypertension patients on follow-up in Jimma University Specialized Hospital, South West Ethiopia.

Methods: This study was conducted at the Jimma University Specialized Hospital (JUSH) from February 2013 – April 2013G.C. Simple random sampling techniques were employed to select 332 participants for this institution-based cross sectional study. A structured questionnaire was designed, translated, pre-tested, and utilized. Data were entered using Epidata3.1 and then exported to SPSS version 16 for analysis. Frequency distributions were used to organize the data and responses obtained. Multivariate logistic regression analysis was used to identify the factors, primarily affecting compliance with antihypertensive treatment.

Result: The mean age of participants was 53.8 + 12.8 years. 55.7% of patients were compliant with antihypertensive medications and 24.8% were compliant in making lifestyle modifications. Factors significantly associated with treatment compliance included: age of the patient (p=0.008), educational level (OR=6. 2 95% CI 1.8, 20.9), number of antihypertensive drugs prescribed (p=0.029), knowledge about hypertension treatment (OR=2.2 95% CI 1.1, 4.3), patient perception about disease severity (OR=3.1 95% CI 1.6, 5.8), and patient knowledge about the benefits of treatment compliance (OR=10.3 95% CI 3.8, 27.8).

Conclusion: In this study, compliance with antihypertensive medication was only reported by 55.7% of patients, and compliance with lifestyle modifications was only reported by 24.8% of patients. The findings from this study can be used to pinpoint the factors that are contributing to poor treatment compliance among patients at the Jimma University Specialized Hospital and to educate them about proper management of hypertension.