Assessing Treatment Adherence In Hypertension Control Among Hypertensive Patients Post Health Education At Kenyatta National Hospital

Abstract

Background: There is a high burden of hypertension in Kenya with documented evidence showing that 24% of Kenyans have an elevated blood pressure and only 15% of those with HBP are aware of it. Low awareness on hypertension status and non-adherence to treatment have been further documented. Treatment adherence is an important indicator of good blood pressure control which is associated with reduction of the risk of cardiovascular diseases and related deaths. Studies on adherence to medication and associated factors are rare. This study was aimed at assessing adherence to hypertension treatment among health educated patients attending medical outpatient clinic and identify associated factors at Kenyatta National Hospital, Kenya. Main objective: To assess treatment adherence in hypertension control among hypertensive patients post health education at Kenyatta National Hospital Methodology: The study employed a descriptive cross-sectional study design. Whereby quantitative methods were used to obtain data on the pharmacological and non-pharmacological adherence. The Hill Bone High blood pressure compliance scale was used to assess the level of adherence. The study area was Kenyatta National Hospital medical outpatient clinics which manage primary hypertensive patients. The study population were primary hypertensive patients diagnosed at least six months or earlier. They also included those on treatment either by pharmacological methods or by lifestyle modification therapies. They must have had health education on hypertension either by nurses, doctors or nutritionists as a group or as an individual patient. Structured questionnaires were employed to collect data from patients concerning pharmacological and non-pharmacological treatment adherence. The questionnaire was interviewer administered. The Hill Bone high blood pressure scale was used to measure the overall adherence levels. The KNH-UoN Ethics & Research committee approved this study. Results: Respondents (n=114) were mainly female (57.9%). They were mostly (31.3%) aged between 40-49 years and majority (73.1%) were from Nairobi county. Main study findings were: Young patients (p=0.011), higher education attainment (p=0.03) and formally employed (p=0.031) were likely to adhere to hypertension treatment. Respondents on high number of antihypertensive medications were likely (p=0.000) to falter in treatment adherence. Respondents with anthropometric parameters above the WHO recommendation were likely to be poorly adherent to hypertension treatment across gender (p<0.05). Conclusion: Adherence to hypertension treatment improved among those patients receiving health education. Age, level of education, pill burden, BMI, Biomarkers, knowledge on hypertension and its treatment are significant predictors of adherence to treatment. Recommendation: The findings underscore the need to allocate more resources and share health messages with hypertension patients on disease progress, risk factors and medication adherence.