Adherence to Lifestyle Modifications and Associated Factors Among Adult Hypertensive Patients Attending Chronic Follow-Up Units of Dessie Referral Hospital, North East Ethiopia, 2020

Abstract

Background

Hypertension is a major health problem throughout the world which affects over one billion people due to severe complications and inadequate control. Even though lifestyle modification is one of the most effective ways to prevent and control hypertension, only little emphasis has been given for it compared with treating hypertension with medication. Therefore, the aim of this study was to assess adherence to lifestyle modifications and associated factors among hypertensive patients attending Dessie referral hospital.

Materials and Methods

Institutional-based cross-sectional study design was conducted among 301 hypertensive patients during May and June, 2020. The study participants were selected with a convenient sampling technique due to the COVID-19 pandemic. Data were collected using pre-tested and structured face to face interviewer-administered questionnaire and checked, cleaned and entered into Epi data version 4.4 and exported to SPSS version 25.0 software for analysis. The associations between independent variables and dependent variable were analyzed using binary logistic regression models.

Results

A total of 301 respondents participated in the study yielding a response of 100%. The overall adherence in this study was only 23.6%. Independent predictors of adherence to lifestyle modifications were divorced (AOR=0.35; 95% CI (0.13–0.94)) and widowed (AOR=0.27; 95% CI (0.10–0.75)), secondary school education (AOR=4.85; 95% CI (1.54–15.22)), no regular income (AOR=0.22; 95% CI (0.08–0.65)) or monthly income of ≥3000 ETB (AOR=5.58; 95% CI (2.46–12.66)), having co-morbidities (AOR=2.37; CI (1.23–4.57)), good knowledge about the disease (AOR=1.83; CI (0.92–3.65)) and good self-efficacy (AOR=3.64; CI (1.75–7.55)).

Conclusion and Recommendations

The overall adherence to recommended lifestyle modifications was very low. The independent predictors were marital status, educational level, monthly income, having co-morbidities, knowledge and self-efficacy. Therefore, multifaceted and collaborative implementation of strategies about lifestyle modifications for hypertension prevention and control are needed to address barriers at the patient, provider, system and community levels.

Keywords:

• hypertension
• adherence
• lifestyle modification
• patient

Acknowledgments

We acknowledge Wollo University for creating an opportunity to run this study. We also extend our gratitude to study participants, data collectors and supervisors.

Abbreviations

ADH, Adult Health Nursing; AUDIT, Alcohol Use Disorders Identification Test; BSc, Bachelor of Science; DASH, Dietary Approach to Stop Hypertension; DRH, Dessie Referral Hospital; DUSOCS, Duke Social Support and Stress Scale; FAST, Fast Alcohol Screening Test; HELM, Hypertension Evaluation of Lifestyle and Management; MPH, Master of Public Health; MSC, Master of Science; RCS, Research and Community Service; RH, reproductive health; SNNPR, Southern Nation and Nationality People Representative.

Data Sharing Statement

The datasets generated or analyzed during this study are available from the corresponding author but will be shared for only reasonable request in order to protect participants’ anonymity.

Ethics and Consent to Participate

Ethical clearance and supportive letter were obtained from Wollo University, College of Medicine and Health Sciences Research and Community Service (RCS) office in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. A supportive letter was given to the hospital and permission was obtained to start data collection. After gaining written consent from each respondent by telling each the objective of the study and assuring confidentiality, data collection was commenced anonymously.

Author Contributions

All authors made a significant contribution to the work reported; whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest for this work.

Additional information

Funding

Wollo University fully covered the financial issues to handle this research.