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Meta-Analysis
. 2021 May;8(1):e001421.
doi: 10.1136/openhrt-2020-001421.

Self-care practice among hypertensive patients in Ethiopia: systematic review and meta-analysis

Degena Bahrey Tadesse  1 , Hadgu Gerensea  2
Affiliations
Meta-Analysis

Self-care practice among hypertensive patients in Ethiopia: systematic review and meta-analysis

Degena Bahrey Tadesse et al. Open Heart. 2021 May.

Abstract

Background: In high-income and low-income countries, including Ethiopia, hypertension (HTN) is a serious public health concern. As a consequence, a massive self-care practice (SCP) is necessary, and the domains of SCP, including adherence to medication, physical activity, weight management, low-salt diet, non-smoking, moderate alcohol usage, and dietary management, are required. However, there is no nationwide study on HTN SCPs in Ethiopia. This meta-analysis, therefore, aimed to estimate the pooled level of HCP among individuals living with HTN in Ethiopia.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline was used to report this systematic review and meta-analysis. We systematically searched the databases PubMed/MEDLINE, Embase, Google Scholar and Science Direct for studies conducted in Ethiopia. All observational studies published until July 2020 were included. Data were analysed using R V.3.5.3 software, and the pooled prevalence with 95% CIs was presented using tables and forest plots. The presence of statistical heterogeneity (I2) within the included studies was evaluated. We used a funnel plot to identify evidence of publication bias. The random-effects meta-analysis model was employed to estimate the pooled proportion of good HTN SCPs.This was submitted for registration with the International Prospective Register of Systematic Reviews in March 2020 and accepted with the registration number CRD42020175743 (https://www.crd.york.ac.uk/PROSPERO).

Results: Our search databases produced 356 papers. Twelve of these papers fulfilled the inclusion and were found suitable for the review. The total population in this study was 3938. Off these hypertensive populations, 44% (95% CI 34 to 53) had good SCP. The subgroup analysis for each component of SCP was done. The subgroup analysis of good adherence to low-salt diet, alcohol abstinence, medication adherence, non-smoking, physical exercise and weight management was 52% (95% CI 39% to 66%), 77% (95% CI 69% to 88%), 65% (95% CI 45% to 85%), 92% (95% CI 88% to 95%), 43% (95% CI 30% to 56%) and 51% (95% CI 32% to 69%), respectively. In conclusion, nearly half of patients with HTN had good SCPs.

Keywords: antihypertensive drugs; hypertension; hypertensive heart disease.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram which shows the study selection of the meta-analysis on levels of hypertension self-care practice in Ethiopia, 2020.
Figure 2
Figure 2
Meta-analysis (forest plot) of the pooled prevalence of overall good self-care practice among hypertensive patients in Ethiopia, 2020.
Figure 3
Figure 3
Funnel plot showing evidence of publication bias across studies.
Figure 4
Figure 4
Result of sensitivity analysis of the studies.
Figure 5
Figure 5
Forest plot for subgroup analysis of medication adherence among hypertensive patients in Ethiopia, 2020.
Figure 6
Figure 6
Forest plot for subgroup analysis of adherence to weight management among hypertensive patients in Ethiopia, 2020.
Figure 7
Figure 7
Forest plot for subgroup analysis of adherence to physical exercise among hypertensive patients in Ethiopia, 2020.
Figure 8
Figure 8
Forest plot for subgroup analysis of adherence to a low-salt diet among hypertensive patients in Ethiopia, 2020.
Figure 9
Figure 9
Forest plot for subgroup analysis of adherence to alcohol abstinence among hypertensive patients in Ethiopia, 2020.
Figure 10
Figure 10
Forest plot for subgroup analysis of adherence to non-smoking among hypertensive patients in Ethiopia, 2020.
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