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

Andualem, Atsedemariam; Gelaye, Habtam; Damtie, Yitayish

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.