Therapeutic inertia and blood pressure control status among adult hypertensive patients in Ethiopia: Prospective observational study

Hypertension is a leading cause of death and disability worldwide, including in developing countries like Ethiopia. The causes may include therapeutic inertia, patient-related risk factors, or medication nonadherence. Therefore, this study aimed to assess the burden of therapeutic inertia and the blood pressure control rate among adult hypertensive patients on follow-up at Jimma Medical Center. A prospective observational study was conducted among adult hypertensive patients who had regular follow-ups at the Ambulatory Cardiac Clinic of Jimma Medical Center from September 22 to December 22, 2022. Patients specific data were collected using a structured data collection tool and through face-to-face interviews. Blood pressure control status was evaluated following the Eighth Joint National Committee guideline recommendations. Data were analyzed with SPSS version 27.0. Factors associated with blood pressure control were identified using binary and multivariate logistic regression analyses. Among 360 participants, 208 (57.8%) were male with a mean age of 54 {+/-} 13.523 years. The blood pressure control rate was 36.9%, and the medication adherence rate was 47.2%. The three-month mean therapeutic inertia score was 0.32 {+/-} 0.51, with over half (56.9%) of participants having a higher therapeutic inertia score than the mean. In multivariable logistic regression analysis, not reducing salt intake (P = 0.003), medication nonadherence (P = 0.009), therapeutic inertia scores during the first, second, and third visits (P = 0.001, 0.013, and 0.041, respectively), and a higher overall therapeutic inertia score (P = 0.013) were significantly associated with uncontrolled blood pressure. The rate of blood pressure control was low. Non-salt reduction, medication nonadherence, and therapeutic inertia were independent predictors of blood pressure control. Therefore, clinicians should adhere to guidelines to reduce therapeutic inertia and provide health education on salt consumption and medication adherence.