ANTIHYPERTENSIVE MEDICATION ADHERENCE AND ASSOCIATED FACTORS AMONG ADULT HYPERTENSIVE PATIENTS AT PUBLIC HOSPITALS IN EAST HARARGHE ZONE, EASTERN ETHIOPIA

Abstract

Background: Adherence refers to the extent to which a person’s behavior of taking medication and making healthy life style changes corresponds with recommendations from the medical or health care providers’ advice. Poor adherence to AHM is an obstacle in the management hypertension and responsible for two-third (2/3) uncontrolled hypertension which results hypertensive complications, infrequent hospital admission, increased health care costs, reduced quality of life, and poor clinical outcome. Objective: To assess antihypertensive medication adherence and associated factors among adult hypertensive patients at selected public hospitals in East Hararghe Zone, Oromia Regional state, Eastern Ethiopia, from August 20, 2023 to September 20, 2023. Methods: A facility-based cross-sectional study was conducted among 364 adult hypertensive patients on follow up at selected public hospitals in eastern Ethiopia. A systematic random sampling technique was used to select the study participants. Data were collected by trained data collectors and supervisors using a pretested structured questionnaire through face-to-face interview and a review of medical charts. Data were coded, entered into Epi-Data version 3.1, and analyzed using STATA version 17.0. Factors associated with medication adherence in the bivariate logistic analysis at a P-value of less than 0.25 were taken to the multivariable logistic analysis to determine factors significantly associated with outcome variable after controlling the confounding variables. An adjusted odds ratio (AOR) with a 95% confidence interval was used to measure the strength of associations and a P-value <0.05 was used to declare statistical significance. Results: The overall level of antihypertensive medication adherence was 59.94% (95% CI: 54.65-65.06). Age between 40-59 years (AOR= 0.41; 95% CI: 0.20-0.84), urban residence (AOR= 2.32; 95% CI: 1.39-3.89), Collage and above education level (AOR= 5.8; 95% CI: 2.69- 12.5), duration of treatment greater than or equal to five years (AOR= 3.36; 95% CI: 1.23-9.19), having knowledge about hypertension and its treatment (AOR= 1.81; 95% CI: 1.07-3.06), distance to healthcare facility less than 10 km’s (AOR= 4.82; 95% CI: 2.06-11.24), having social support (AOR= 1.77; 95% CI: 1.03-3.02), and taking three and above medications (AOR = 0.23; 95% CI: 0.107-0.52) have shown statistically significant association with medication adherence. Conclusion and Recommendations: In this study, the magnitude of medication adherence was found to be very low. Factors such as age, residence, educational status, duration of treatment, social support, knowledge, distance from healthcare facility, and number of medications have shown statistically significant association with medication adherence. The government and health bureau should increase accessibility of healthcare facility, strengthen behavior of supporting each other and healthcare professionals have to simplify treatment regimen and educate the patients about hypertension and its treatment.