The association between medication adherence and cognitive function impairment among hypertensive patients a case-control study in Mekelle, northern Ethiopia
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Date
2020-10
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Addis Abeba University
Abstract
Background: Hypertension is a global public health problem. In developing countries, the high
prevalence of hypertension followed by poor hypertension control remains a significant public
health challenge. The brain is one of the main target organs affected by hypertension, excluding
age hypertension is the most important risk factor for cerebrovascular pathology leading to
cognitive function impairment. However, the level of antihypertensive medication adherence
among hypertension patients and the difference in the development of cognitive function
impairment is not well studied.
Objective: This study aimed to assess the association between medication adherence and
cognitive function impairment among hypertensive patients in Mekelle, northern Ethiopia from
April to September 2020 G.C.
Method: An unmatched case-control study design was conducted in the selected health facilities
in Mekelle, Ethiopia from April to September 2020. The study population was hypertensive
patients, aged 60 years and above and who have been on antihypertensive medications for at
least 6 months. A sample size of 106 cases and 106 controls were included in the study,
participants with cognitive function impairment were considered as cases, and participants
without cognitive function impairment were controls. The data collection was done twice and the
data were collected by reviewing the medical chart of patients and interviewer-administered
questionnaire, by trained data collectors. Mini-Mental State Examination was used to assess the
cognition status of the study participants and to assess the antihypertensive medication
adherence, Morisky Medication Adherence Scale was used. The collected questionnaires were
entered into Epi data version 3.1 and exported to SPSS version 23 for cleaning and further
analysis. Bivariable and multivariable logistic regression was used for analysis. An adjusted odds
ratio along with a 95% confidence interval and a p-value of < 0.05 was used for declaring
statistical significance.
Result: The prevalence of medication adherence was found to be 34(32.1%) among cases and
84(79.2%) among controls. Medication adherence was independently significantly associated to
cognitive function impairment with [AOR =7.77, 95% CI: (3.44 -17.24)]. The odds of cognitive
function impairment was 7.7 times more among antihypertensive medication non-adherent
participants compared to those who were adherent. Marital status and educational status were
also found to be significantly associated with cognitive function impairment
Conclusion and recommendation: There is an association between antihypertensive medication
adherence and cognitive function impairment after controlling for possible confounders. Further
work needs to be done by the health professionals on informing patients about the consequences
of elevated and/ or uncontrolled BP and on the benefits of medication adherence and the
consequences of non-adherence.
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Hypertensive patients