Predictors of adherence to Hypertension Self-management practices among older persons attending a rural hospital in Uganda.

Abstract

Background: Hypertension self-management practices have proven beneficial in controlling blood pressure and preventing complications as part of the chronic care model. However, these practices among older persons 50 years and above have not been well evaluated in sub Saharan Africa despite the emerging hypertension burden in the region.

Objective: The study determined adherence to hypertension self-management practices and factors associated with good adherence among older persons attending the Non-Communicable Diseases clinic in rural Eastern Uganda.

Methods: In a facility-based cross-sectional study, individuals 50 years and above were selected consecutively from the bi-weekly hypertension out-patient clinic from January-February 2023. The adopted Hypertension Self-Care Activity Level Effects (H-SCALE) questionnaire was used to assess adherence to the self-management practices. The generalised linear model was used to determine predictors of adherence to the self-management practices.

Results: Of the 74 hypertensive patients, level of adherence to the hypertension self-management practices of atleast 4 out of the 6 practices was 27 (36.5%). Adherence to diet, weight management, medication adherence, aerobic physical activity, non-smoking and recommended alcohol intake was 0(0%), 23(31.1%), 33(44.6%), 37(50.0%), 67 (90.5%) and 74(100%) respectively. Being married and having hypertension for less than 4 years were associated with good adherence p-value 0.01 and 0.03 respectively.

Conclusions: Social factors like marriage and duration with hypertension were associated with better adherence to hypertension self-management practices. We recommend better implementation of the chronic care model to improve hypertension control in the community.