Yousuf Jemal, Roba Kedir Teji, Ahmed Nesredin, Belsty Tefera, Wondimneh Fenta, Daba Lema, Teshager Tilahun, Ketema Indeshaw
Department of Nursing, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia.
School of Nursing, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
PLoS One. 2025 May 28;20(5):e0322655. doi: 10.1371/journal.pone.0322655. eCollection 2025.
Blood pressure regulation depends heavily on adherence to antihypertensive medication. Additionally, poor adherence to antihypertensive drugs leads to the development of hypertensive complications. However, little is knowen about the factors affecting antihypertensive medication adherance in Ethiopia, and no study has been conducted in the study settings. Therefore, this study aimed to assess antihypertensive medication adherence and associated factors among adult hypertensive patients in selected public hospitals in East Hararghe Zone, Eastern Ethiopia.
A facility-based quantitative cross-sectional study was conducted from August 20 to September 20, 2023, among 364 adult hypertensive patients on follow-up in selected public hospitals of eastern Ethiopia. A simple random sampling method was used to select the study participants. Data were collected through face-to-face interviews using a pretested structured questionnaire. Drug adherence status was assessed using Morisky Medication Adherence Scale-8. Data was analyzed using Epi-Data 3.1 and STATA 17.0, applying bivariate and multivariate logistic regression techniques. The association was declared using p < 0.05.
The overall level of adherence to antihypertensive medications was 59.94% (95% CI: 54.65-65.06). Urban residence (AOR = 1.96; 95% CI: 1.21-3.18), college and higher education level (AOR = 3.41; 95% CI: 1.69-6.87), health insurance coverage user (AOR = 2.00; 95% CI: 1.11-3.59), having knowledge about hypertension (AOR = 1.75; 95% CI: 1.03-2.97), distance to health care facility less than 10 kilometers (AOR = 4.6; 95% CI: 1.97-10.73), having social support (AOR = 1.86; 95% CI: 1.13-3.08), and taking three and above medications (AOR = 0.28; 95% CI: 0.12-0.64) showed a statistically significant association with medication adherence.
Adherence to antihypertensive medication was found to be low. This study identified place of residence, educational status, health insurance coverage, social support, knowledge of hypertension, distance from a health care facility, and number of medications as independent predictors of medication adherence. Therefore, improving accessibility of health care facilities, strengthening health insurance coverage, and providing health education about hypertension will improve antihypertensive medication adherence.
血压调节在很大程度上取决于对抗高血压药物的依从性。此外，对抗高血压药物的依从性差会导致高血压并发症的发生。然而，在埃塞俄比亚，人们对影响抗高血压药物依从性的因素知之甚少，且在本研究环境中尚未开展过相关研究。因此，本研究旨在评估埃塞俄比亚东部哈勒尔格东部地区选定公立医院成年高血压患者的抗高血压药物依从性及相关因素。
2023年8月20日至9月20日，在埃塞俄比亚东部选定公立医院对364名接受随访的成年高血压患者进行了一项基于机构的定量横断面研究。采用简单随机抽样方法选取研究参与者。通过使用预先测试的结构化问卷进行面对面访谈收集数据。使用Morisky药物依从性量表-8评估药物依从性状况。使用Epi-Data 3.1和STATA 17.0进行数据分析，应用二元和多元逻辑回归技术。以p < 0.05表示存在关联。
抗高血压药物的总体依从水平为59.94%（95%置信区间：54.65 - 65.06）。城市居住（调整后比值比[AOR]=1.96；95%置信区间：1.21 - 3.18）、大专及以上教育水平（AOR = 3.41；95%置信区间：1.69 - 6.87）、医疗保险覆盖使用者（AOR = 2.00；95%置信区间：1.11 - 3.59）、了解高血压（AOR = 1.75；95%置信区间：1.03 - 2.97）、到医疗机构的距离小于10公里（AOR = 4.6；95%置信区间：1.97 - 10.73）、有社会支持（AOR = 1.86；95%置信区间：1.13 - 3.08）以及服用三种及以上药物（AOR = 0.28；95%置信区间：0.12 - 0.64）与药物依从性存在统计学显著关联。
发现抗高血压药物的依从性较低。本研究确定居住地点、教育状况、医疗保险覆盖、社会支持、高血压知识、与医疗机构的距离以及药物数量为药物依从性的独立预测因素。因此，改善医疗设施的可及性、加强医疗保险覆盖并提供有关高血压的健康教育将提高抗高血压药物的依从性。
