Adherence to Healthy Lifestyle and Associated Factors among Hypertension Patients Under Follow-up at Public Hospitals in Northwest Amhara, Ethiopia: A multi-center cross-sectional study

ObjectiveThe aim of this study was to assess adherence to a healthy lifestyle and associated factors among hypertension patients at selected public hospitals in Northwest Amhara, Ethiopia. Study designA multi-center hospital-based cross-sectional study design was conducted. Study settingThe study was conducted at primary and general hospitals in Northwest Ethiopia. Primary and secondary outcome measuresAdherence to a healthy lifestyle was assessed with respect to adherence to diet, physical exercise, smoking, and moderation of alcohol consumption, specifically assessed with the 4-item Fast Alcohol Screening Test as the primary outcomes, and factors associated with adherence to a healthy lifestyle were secondary outcomes. ParticipantsEight hundred and forty adult hypertension patients were involved in this study; of these, four hundred forty-eight were men and three hundred ninety-two were women. Systematic sampling techniques were used to select study participants. Data were collected using structured interviewer-administered questionnaire and chart review. We analyzed the data using SPSS V.20 statistical software. An adjusted odds ratio with a 95% confidence interval and a p-value <0.05 was used to determine predictors of adherence to a healthy lifestyle. ResultThe overall good adherence in this study was 21.7% (95% CI: 19.0 to 24.6). Being female (AOR = 2.03; 95% CI: 1.38 to 2.98), having primary education (AOR = 2.07; 95% CI: 1.06 to 4.03), a duration of hypertension diagnosis of 2-4 years (AOR = 3.14; 95% CI: 1.83 to 5.39), having good knowledge (AOR = 3.06; 95% CI: 2.02 to 4.64), and getting good social support (AOR = 2.89; 95% CI: 1.97 to 4.25) were significant predictors of good adherence to healthy lifestyle modification practices. ConclusionThe overall good adherence to recommended healthy lifestyle modification practices was low. Good adherence was associated with being female, having primary education, having been diagnosed with hypertension for a period of time, having good knowledge, and receiving social support. Keywords: hypertension; healthy lifestyle; adherence; Ethiopia. STRENGTH AND LIMITATION OF THE STUDY Eleven items on the Likert scale and the Duke Social Support and Stress scale were used to assess level of social support, which was a globally accepted protocol. The 4-item Fast Alcohol Screening Test (FAST), which is the short version of the alcohol disorders identification test (AUDIT), was also used to assess adherence to alcohol consumption. It is challenging to determine the causal linkage between adherence to a recommended healthy lifestyle and associated factors due to the cross-sectional nature of the study design. Regarding diet intake, it was challenging to quantify exactly what they consumed because the diet measuring questionnaire was subjective. The other limitation of the study is that the questionnaire employed in this study might be prone to social desirability and recall bias.