Association of lifestyle modification and pharmacological adherence on blood pressure control among patients with hypertension at Kenyatta National Hospital, Kenya: a cross-sectional study

Kimani, Samuel; Mirie, Waithira; Chege, Margaret; Okube, Okubatsion Tekeste; Muniu, Samuel

doi:10.1136/bmjopen-2018-023995

Cited by 44 publications

(58 citation statements)

References 82 publications

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“…However, the result of this study was lower than a study conducted at Mizan Tepi hospital which was 66.7% (25), Durame hospital which was 72.7% (16), and Addis Ababa which was 77% (10). In contrast, the nding of this study was higher than a study conducted at Hiwot Fana and Jugola hospital which was 37.9% (26), Nekemite hospital (27) which was 31.1%, Saudi which was 25.6% (33), Ghana which was 28% (35) and Iran which was 27% (28). This discrepancy might be due to differences in life style, culture, economic status, access to health care facilities and level of education of the general public.…”

Section: Discussioncontrasting

confidence: 70%

Self-care Practice and Associated Factors Among Hypertensive Follow Up Patients at East Gojam Zone Public Hospitals, North West Ethiopia, 2021

Zeleke¹,

Assefa²,

Sergo³

et al. 2021

Preprint

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Background: Self-care practice is crucial for the prevention and management of Hypertension. Poorly controlled hypertension leads to cardiovascular complication as well as organ damage. Despite the availability of several effective pharmacologic and non-pharmacologic therapies, hypertension control remains suboptimal. Self-care practices allow hypertensive patients to have improved quality of life by avoiding complication and decrease health care expenditure. Objective: we assessed self-care practice and its associated factors among Hypertensive Follow up patients at East Gojjam Zone public hospitals, Northwest Ethiopia, 2020.Methods: Institution based cross sectional study was conducted by both quantitative and qualitative methods from October 1-30, 2020. Epi data version 3.1 and SPSS version 25.0 were used for data entry and for analysis respectively. Descriptive statistics and binary logistic regression analysis was employed. Adjusted odds ratios were used to ascertain effect sizes for any association between the dependent and associated variables while significance level at p value of 0.05 was determined using 95% confidence intervals. Result: Out of 480 patients included in the study 51% have Poor self-care practices. About 44.6%, 92.5%, 82.8%, 62.5% of respondents were poor adherent to antihypertensive medications, low diet quality, poor practiced to physical activity, poor practice to weight management respectively. Some of the respondents 3.3%, 9.8% were smokers and were alcohol drinkers respectively. Educational status who cannot read and write (AOR=3.153, 95% CI: 1.674-5.939), no co morbidity (AOR = 0.418, 95% CI: 0.263-0.663), uncontrolled blood pressure status (AOR = 2.141, 95% CI: 1.271- 3.609), poor social support status (AOR = 2.587, 95% CI: 1.544-4.334) and unfavorable attitude (AOR= 3.193, 95% CI: 1.951-5.225) showed significant statistical association with poor self-care practice.Conclusion: The level of hypertension self-care practices found to be low. Therefore, education towards hypertension self-care practices should be strengthened for patients living with hypertension. Special attention should be given to patients with low educational level that cannot read and write, patients with co morbidity, uncontrolled state of hypertension, poor social support and those with unfavorable attitude towards hypertension management modalities.

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Section: Discussioncontrasting

confidence: 70%

Self-care Practice and Associated Factors Among Hypertensive Follow Up Patients at East Gojam Zone Public Hospitals, North West Ethiopia, 2021

Zeleke¹,

Assefa²,

Sergo³

et al. 2021

Preprint

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“…A study from Uganda showed that awareness about hypertension was 28.2%, and only 9.4% of participants had controlled their BP [ 35 ]. A study conducted in Kenya showed that about 53.6% of patients believed they should stop taking antihypertensive medication once hypertension is controlled [ 85 ]. A study from Malawi showed that 62% of the hypertensive patients were aware of their blood pressure [ 86 ].…”

Section: Resultsmentioning

confidence: 99%

Reasons for poor blood pressure control in Eastern Sub-Saharan Africa: looking into 4P’s (primary care, professional, patient, and public health policy) for improving blood pressure control: a scoping review

Sorato

Davari

Kebriaeezadeh

et al. 2021

BMC Cardiovasc Disord

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Aim Hypertension control in Sub-Saharan Africa (SSA) is the worst (less than one out of ten) when compared to the rest of the world. Therefore, this scoping review was conducted to identify and describe the possible reasons for poor blood pressure (BP) control based on 4Ps’ (patient, professional, primary healthcare system, and public health policy) factors. Methods PRISMA extension for scoping review protocol was used. We systematically searched articles written in the English language from January 2000 to May 2020 from the following databases: PubMed/Medline, Embase, Scopus, Web of Science, and Google scholar. Results Sixty-eight articles were included in this scoping review. The mean prevalence of hypertension, BP control, and patient adherence to prescribed medicines were 20.95%, 11.5%, and 60%, respectively. Only Kenya, Malawi, and Zambia out of ten countries started annual screening of the high-risk population for hypertension. Reasons for nonadherence to prescribed medicines were lack of awareness, lack of access to medicines and health services, professional inertia to intensify drugs, lack of knowledge on evidence-based guidelines, insufficient government commitment, and specific health behaviors related laws. Lack of screening for high-risk patients, non-treatment adherence, weak political commitment, poverty, maternal and child malnutrition were reasons for the worst BP control. Conclusion In conclusion, the rate of BP treatment, control, and medication adherence was low in Eastern SSA. Screening for high-risk populations was inadequate. Therefore, it is crucial to improve government commitment, patient awareness, and access to medicines, design country-specific annual screening programs, and empower clinicians to follow individualized treatment and conduct medication adherence research using more robust tools.

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“…This was consistent with reports from other studies which noted BP control rates of between 34 and 49%. 20 , 50 , 51 Elevated BP is the number one risk factor for cardiovascular diseases and the control and treatment of hypertension can result in a reduced incidence of complications. 52 Health workers at Mutare Provincial Hospital OPD must devise strategies to promote the control of hypertension among patients.…”

Section: Discussionmentioning

confidence: 99%

The Nexus Between Adherence to Recommended Lifestyle Behaviors and Blood Pressure Control in Hypertensive Patients at Mutare Provincial Hospital, Zimbabwe: A Cross-Sectional Study

Tozivepi¹,

Takawira²,

Chikaka³

et al. 2021

PPA

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Patients and Methods: A cross-sectional study was conducted using BP readings from three consecutive months. A structured interviewer-administered and pretested questionnaire with components derived from the World Health Organization Stepwise Survey was employed to extract information from 350 purposively selected participants. Measurement of BP was based on the Eighth Joint National Committee Guidelines. Bivariate and multivariate logistic regression analyses were computed using the SPSS package. Results: The mean age of the 350 participants was 67±11.38 years. Males made up 35% of the participants and BP control was achieved in 41.4% of the patients. Only 5.1% of the participants reported adherence to all the recommended lifestyle behaviors. Low adherence rates were reported for diet, medication, and physical activity. Bivariate analysis showed that participants who adhered to antihypertensive treatment and alcohol recommendations had reduced odds of having uncontrolled hypertension, while consuming deep-fat fried foods ≥3 times a week was associated with higher odds of uncontrolled BP (p<0.1). Logistic regression analysis revealed that participants who ate traditional whole-grain "sadza" or porridge were more likely to have controlled BP [adjusted odds ratio (AOR): 1.6; 95% confidence interval (CI): 1.0-2.5] while those who did not add salt at the table had reduced odds of having uncontrolled BP by 40% (AOR: 0.6; 95% CI: 0.4-0.9). Conclusion: Overall, adherence to the recommended lifestyle behaviors which are known to be effective in controlling BP in Mutare was poor. Health workers should include comprehensive health education messages on the importance of compliance with dietary, medication, and physical exercise recommendations when counseling patients. The intervention crafting process should focus on identifying enablers of the recommended lifestyle behaviors in the community and the health delivery system.

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Association of lifestyle modification and pharmacological adherence on blood pressure control among patients with hypertension at Kenyatta National Hospital, Kenya: a cross-sectional study

Cited by 44 publications

References 82 publications

Self-care Practice and Associated Factors Among Hypertensive Follow Up Patients at East Gojam Zone Public Hospitals, North West Ethiopia, 2021

Self-care Practice and Associated Factors Among Hypertensive Follow Up Patients at East Gojam Zone Public Hospitals, North West Ethiopia, 2021

Reasons for poor blood pressure control in Eastern Sub-Saharan Africa: looking into 4P’s (primary care, professional, patient, and public health policy) for improving blood pressure control: a scoping review

The Nexus Between Adherence to Recommended Lifestyle Behaviors and Blood Pressure Control in Hypertensive Patients at Mutare Provincial Hospital, Zimbabwe: A Cross-Sectional Study

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