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    Antihypertensive medications adherence and associated uncontrolled blood pressure among hypertensive patients in Ethiopia: Systematic review and meta-analysis

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    Author
    Desta, Melaku
    Yibeltal, Desalegn
    Memiah, Peter
    Ayenew, Temesgen
    Mulugeta, Henok
    Gedefaw, Mihretie
    Bewket Kidanie, Bekalu
    Birhanu, Molla Yigzaw
    Tessema, Zenaw
    Mengist, Belayneh
    Alene, Muluneh
    Simieneh, Muluye Molla
    Ewunetie, Atsede Alle
    Shiferaw, Wondimeneh Shibabaw
    Yeshitila, Yordanos Gizachew
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    Date
    2022-01-01
    Journal
    International Journal of Africa Nursing Sciences
    Publisher
    Elsevier
    Type
    Article
    
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    https://doi.org/10.1016/j.ijans.2022.100404
    Abstract
    Background: Despite remarkable progress in the reduction of communicable diseases, non-communicable diseases still pose a threat worldwide. One such non-communicable disease is hypertension which remains a major public health problem in Sub-Saharan Africa. Adherence to antihypertensive medication regimens is paramount in reducing its burden. Study findings in Ethiopia regarding adherence to antihypertensive medications and their impact on blood pressure control have been inconclusive and inconsistent. This systematic review and meta-analysis aimed to estimate the pooled adherence to antihypertensive medications and their association with uncontrolled blood pressure among hypertensive patients in Ethiopia. Methods: International databases including PubMed, Web of Science, SCOPUS, CINAHL, PsycINFO, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All identified observational studies and/or predictors were included, and I2 statistics were used to assess the heterogeneity of the studies. A random-effects model was computed to estimate the pooled adherence level and its association with uncontrolled blood pressure. Results: The random-effect meta-analysis showed that a pooled national antihypertensive medication adherence among hypertensive patients was 65.1% (95% CI: 61.6%, 68.6%). The highest medications adherence was 83.5% (95% CI: 77.0%, 89.9%) occurring in the Somali Region with the lowest medication adherence being 58.5% (95% CI: 47.7%, 69.3%) in the Tigray Region. The meta-analysis suggested a significant increase in medication adherence among patients who had good knowledge of hypertension [POR = 4.26 (95% CI: 4.26 (2.70, 6.72)] and 2.54 times increase in the odds among patients who had co-morbidities [POR = 2.54 (95% CI: 1.06, 6.07)]. This meta-analysis also revealed a 51% reduction of uncontrolled blood pressure among patients who adhered to an antihypertensive medication regimen [POR = 0.49 (95% CI: 0.34, 0.69)]. Conclusions: Two of every three hypertensive patients have adhered to a medication regimen that was associated with reduced odds of uncontrolled blood pressure. Therefore, interventions of highest priority to increase antihypertensive medication adherence are aimed at improving knowledge of hypertension and identifying or screening hypertensive patients who have comorbidities. The Federal Ministry of Health and other relevant stakeholders should increase efforts in the prevention of uncontrolled blood pressure through education on adherence to medication regimens with a focus on modifiable risk factors.
    Keyword
    Antihypertensive medication adherence
    Ethiopia
    Meta-analysis
    Uncontrolled blood pressure
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/18372
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ijans.2022.100404
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