Knowledge, attitude and practices of lifestyle modification and associated factors among hypertensive patients on-treatment follow up at Yekatit 12 General Hospital in the largest city of East Africa: A prospective cross-sectional study
Authors: Kebede Taye , Taddese Zaid , Girma Abiot 
Published: January 2022

Background
Hypertension is a devastating global public health challenge; studies indicated that Ethiopia has been affected by the burden of hypertension especially in urban areas. The overall prevalence of hypertension in Ethiopia was estimated to be 19.6% (23.5% in urban and 14.7% in rural population). Along with medical management of hypertension, appropriate lifestyle modification is a crucial and inexpensive means of hypertension control. The main purpose of the study was therefore to assess knowledge, attitude and practice of lifestyle modification among patients on follow up for hypertension treatment at Yekatit 12 General Hospital.

Methods
A prospective cross-sectional study design was applied in Yekatit 12 General Hospital from October 28, 2018, to February 28, 2019, by allotting proportionate samples from the two chronic outpatients departments (OPD). Using single proportion sampling techniques, the study participants were selected and the total sample size calculated was 405. Primarily, clinical measurements were made according to the international standard set to verify true hypertensive patient’s inclusions. Then, data about socio-demographic characteristics, lifestyle modification related to knowledge, attitude and practices were comprehensively collected using an interviewer-administered structured questionnaire. The collected data was entered into Epi-data exported to SPSS Window version of 22 for analysis. All variables with ρ-value less than 0.05 in the final model were considered as independently associated with knowledge, attitude and practices of patients’ lifestyle modification. The strength of association was described by Odds Ratio (OR) at the corresponding CI of 95%.

Results
The overall sampled hypertensive patients as compared to the planned sample size was 95.5% (n = 387), out of which 53.5% (n = 207) was male patients. The mean age was 50 years with a standard deviation of 14.4. The study revealed that 67.7% [95% CI (65.32%, 70.08%)] were knowledgeable; and 54.0% [95% CI (51.34%, 56.6%)] were reported to have favorable attitude towards lifestyle modification. Regarding their practices, 38% [95% CI (19.91%, 57.49%] of the respondents had good practices. Their monthly income [AOR = 2.39, 95% CI (1.12, 5.11)] and duration on-treatment follow up since diagnosed with hypertension [AOR = 4.39, 95% CI (1.20, 16.03)] were independently associated with knowledge. Concerning their damned practices, age [AOR = 7.71, 95% CI (2.4, 24.8)] and knowledge [AOR = 3.94, 95% CI (2.01, 7.72)] were independently associated with the practices.

Conclusion
Though the encouraging high knowledge status and favourable attitudes towards lifestyle modification among hypertensive patients, the practices are among the lowest findings report in all standards. Hence, older patients, jobless patients, and low-income patients and patients on long-term treatment follow up who were diagnosed with hypertension before 10 years needs special attention and interventions by the country NCDs policy formulators to rise their non-pharmacological practices to control high blood pressure and its consequences.