埃塞俄比亚高血压患者对抗高血压药物的依从性及相关因素：系统评价与荟萃分析

Adherence to antihypertensive medications and associated factors among hypertensive patients in Ethiopia: Systematic review and meta-analysis.

作者信息

Tola Gemeda Assefa, Regassa Lemma Demissie, Weldesenbet Adisu Birhanu, Merga Bedasa Taye, Legesse Nanti, Tusa Biruk Shalmeno

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Department of Public Health and Health Policy, School of Public Health, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia.

出版信息

SAGE Open Med. 2020 Dec 22;8:2050312120982459. doi: 10.1177/2050312120982459. eCollection 2020.

DOI:10.1177/2050312120982459

PMID:33489230

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7768850/

Abstract

The foundation of controlling hypertension is adherence to antihypertensive medication adherence. This systematic review and meta-analysis aimed to assess the magnitude and associated factors of adherence to antihypertensive medication among adult hypertensive patients in Ethiopia. A comprehensible bibliographic searching was conducted from PubMed, EMBASE, Scopus, and Web of Science core collection. All published and unpublished studies that had been accessible before 31 May 2020, and written in English were eligible. Joanna Briggs Institute assessment tool was used to evaluate the quality of the findings of the included studies. Stata software 16.0 was used to analyze the data. Study-specific estimates were pooled to determine the overall prevalence estimate across studies using a random-effects meta-analysis model. Publication bias and heterogeneity were checked. Fourteen studies with a total of 4938 hypertensive patients were included in the final systematic review and meta-analysis. The pooled prevalence of medication adherence among hypertensive patients in Ethiopia was 65.41% (95% confidence interval: 58.91-71.91). Sub-group analysis shown that the pooled prevalence of medication adherence was the highest (69.07%, 95% confidence interval: 57.83-80.31, = 93.51) among studies using questionnaire technique whereas the lowest in Morisky Medication Adherence Scale eight-items (60.66%, 95% confidence interval: 48.92-72.40, = 97.16). Moreover, medication adherence was associated with the presence of comorbidities (pooled odds ratio = 0.23, 95% confidence interval: 0.07-0.38, = 0.030, = 54.9%) and knowledge about the disease and its management (pooled odds ratio = 2.98, 95% confidence interval: 1.72-4.24, = 0.04, = 55.55%) but not with place of residence (pooled odds ratio = 1.22, 95% confidence interval: 0.51-1.93, = 0.00, = 76.9%). Despite a lack of uniformity among included studies, adherence to antihypertensive medication among the hypertensive population in Ethiopia was moderate. The presence of comorbidities and/or complications reduced the odds of adherence whereas having good knowledge about the disease increased chance of medication adherence among hypertensive patients.

摘要

控制高血压的基础是坚持服用抗高血压药物。本系统评价和荟萃分析旨在评估埃塞俄比亚成年高血压患者抗高血压药物依从性的程度及其相关因素。通过PubMed、EMBASE、Scopus和Web of Science核心合集进行了全面的文献检索。所有在2020年5月31日前可获取且以英文撰写的已发表和未发表研究均符合条件。使用乔安娜·布里格斯研究所评估工具来评估纳入研究结果的质量。使用Stata软件16.0进行数据分析。采用随机效应荟萃分析模型汇总研究特定估计值，以确定各研究的总体患病率估计值。检查了发表偏倚和异质性。最终的系统评价和荟萃分析纳入了14项研究，共4938名高血压患者。埃塞俄比亚高血压患者药物依从性的合并患病率为65.41%（95%置信区间：58.91 - 71.91）。亚组分析显示，在使用问卷调查技术的研究中，药物依从性的合并患病率最高（69.07%，95%置信区间：57.83 - 80.31，I² = 93.51），而在Morisky药物依从性量表八项版中最低（60.66%，95%置信区间：48.92 - 72.40，I² = 97.16）。此外，药物依从性与合并症的存在（合并比值比 = 0.23，95%置信区间：0.07 - 0.38，P = 0.030，I² = 54.9%）以及对疾病及其管理的了解（合并比值比 = 2.98，95%置信区间：1.72 - 4.24，P = 0.04，I² = 55.55%）相关，但与居住地点无关（合并比值比 = 1.22，95%置信区间：0.51 - 1.93，P = 0.00，I² = 76.9%）。尽管纳入研究之间缺乏一致性，但埃塞俄比亚高血压人群的抗高血压药物依从性处于中等水平。合并症和/或并发症的存在降低了依从性几率，而对疾病有良好了解则增加了高血压患者药物依从性的机会。