Self-care practice and associated factors among hypertensive patients in Ethiopia: Umbrella review of systematic review and meta-analysis studies

Background

Self-care practices are vital for managing high blood pressure. Four systematic reviews and meta-analysis in Ethiopia have shown inconsistent prevalence rates and varying quality scores for hypertensive self-care. This umbrella review aims to unify these findings into a comprehensive document for better comparison. It is the first of its kind in Ethiopia and seeks to support clinicians and policymakers in preventing hypertension-related complications.

Methods

This umbrella review incorporated four systematic reviews and meta-analyses identified through a literature search across PubMed, ScienceDirect, Web of Science, the Cochrane Database of Systematic Reviews, and the Database of Abstracts of Reviews of Effects, specifically targeting systematic reveiw and meta-analysis) studies on hypertension self-care practices in Ethiopia. Data from the included systematic review and meta-analysis studies were extracted using a standardized data abstraction form created in an Excel spreadsheet. The quality of all relevant systematic reviews and meta-analyses was assessed using the AMSTAR-2 (Assessment of Multiple Systematic Reviews) tool. R software version 4.3.2 was used to perform overall data synthesis and statistical analysis. The overall pooled prevalence and effect sizes were analyzed using a random-effects model.

Results

Four studies with 21,479 hypertensive patients were included. The overall pooled prevalence of good self-care practice among hypertensive patients in Ethiopia is 41 % (95 % CI 38 %, 44 %, I² =96 %, P = 0.001). Attending formal education (OR=1.56, 95 % CI: 1.23, 2.74), good knowledge of hypertension (OR=1.98, 95 % CI: 1.45, 3.01) were significantly associated with self-care practice among hypertensive patients in Ethiopia.

Conclusions

This umbrella review revealed low self-care practices among hypertensive patients in Ethiopia, with the poorest adherence in physical activity and the highest in smoking cessation. Education and knowledge about hypertension were key influences on self-care. The review suggests promoting physical activity, targeted education, and integrating these strategies into public health policies, alongside conducting nationwide studies to improve interventions.