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

ABSTRACT Objective The 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 design A multi-center hospital-based cross-sectional study design was conducted . Study setting The study was conducted at primary and general hospitals in Northwest Ethiopia . Primary and secondary outcome measures Adherence 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 . Participants Eight 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 . Result The 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 . Conclusion The 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 .