Determinants Of Uncontrolled Hypertension Among Hypertensive Patients Having Follow Up At Public Health Facilities Of Adea Berga District, 2023

Abstract

Background: Only 21% of hypertensive patients attain their blood pressure target at global level. When hypertension is not adequately controlled, its negative effects increased. Many determinants were not adequately addressed. This study may provide further insights into hypertension control by providing additional evidences on key factors like therapeutic inertia and medical advice. Objective: The objective of this study was to identify determinants of uncontrolled hypertension among adult hypertensive patients having follow up at public health facilities of Adea Berga district from September 1 to 30, 2022. Methods: A Facility-based unmatched case control study was conducted. Study period was from September 1 to October 30, 2022. A total of 264 (88 cases and 176 controls) respondents were selected for the study by systematic random sampling. Structured questionaries were used to collect data from participants. EPI Info version 7.2.4 software was used for data entry and cleaning which was then exported to SPSS version 26 for further analysis. Binary logistic regression model was fitted and multivariable analysis was conducted to see the association between determinant factors and uncontrolled hypertension. Results were presented by tables and figure. Result: Of the 264 eligible patients attending at the chronic follow up care clinics in the three health facilities in Adea Berga district in the two months of data collection, 264 participated in this study making response rate of 100%. Duration of hypertension >1 to  5 years (AOR = 0.229; 95 % CI 0.069, 0.764), body mass index 25 Kg/m2 (AOR = 8.461; 95 % CI 3.232, 22.151), DASH diet non-adherence (AOR= 5.631; 95% CI 2.298, 13.801), not being well advised (AOR= 3.355; 95% CI 1.420, 7.928), non-adherence to salt reduction (AOR= 3.857; 95%CI 1.183, 12.574), non-adherence to adequate physical exercise (AOR= 3.896; 95% CI 1.224, 12.402), availability of antihypertensive drugs in health facility (AOR= 0.246; 95% CI 0.078, 0.779), medication non-adherence (AOR= 4.628; 95 % CI 1.914, 11.188) and therapeutic inertia (AOR= 3.069; 95 % CI 1.153, 8.164) have shown significant association with uncontrolled hypertension (p<0.05). Conclusion: This study revealed that hypertension duration >1 to  5 years from time of diagnosis, body mass index  25 Kg/m2, DASH diet non-adherence, poor advice given by healthcare providers for patients, non-adherence to salt reduction, non-adherence to adequate physical exercise, availability of antihypertensive drugs in health facility, medication nonadherence and therapeutic inertia, are determinants of uncontrolled hypertension. Provider and VII system related factors should be well addressed in addition to behavioral and medication related factors to tackle the problem of uncontrolled hypertension