DEPARTMENT OF COMPRENSIVE

NURSE

MAGNITUDE
MAGNITUDE OF
OF HAYPERTENSION
HAYPERTENSION AND
AND FACTORS
FACTORS ASSOCIATED
ASSOCIATED
WITH
WITH POOR
POOR TREATMENT
TREATMENT OUTCOME
OUTCOME AT
AT HIWOT
HIWOT FANA
FANA AND
AND
JUGOL
JUGOL HOSPITAL,
HOSPITAL, HARAR
HARAR TOWN,
TOWN, EASTERN
EASTERN ETHIOPIA.
ETHIOPIA.

Feb,18
Feb,18 to
to Apr
Apr 18,
18, 2021
2021 1
HARAR,
HARAR, EASTERN
EASTERN ETHIOPIA
ETHIOPIA
GROUP MEMBERS
1. ANA ABDI
2. IBSA MOHAMMED
3. ISAK ABAS
4. MURAD SHERAFO

ADVISOR:
MAJOR ADVISOR: MR. ABAS.M (BSc. MSc)

CO-ADVISOR: MR. YENEBEB (BSc. MSc)

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 Outlines
• Introduction
• Statement of problem
• Justification of study
• Objective
• Methodology
• Operational definition
• Acknowledgement
• References
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 Introduction
• Hypertension (HTN) is persistent elevation of blood
pressure(> 140/90) [1].
• And diastolic blood pressure >90 mmHg
• It is one of the most significant risk factors for
cardiovascular (CV) morbidity and mortality [2].
• Hypertension causes 7.1 million premature deaths each year
worldwide and accounts for 13% of all deaths, globally [3].

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• The burden of hypertension is currently centered in
economically developed countries largely owing to
change in life style [2].
• The WHO estimates indicate that up to three-quarters of
the world’s hypertensive population will be in
economically developing countries by the year 2025 [4].
• In Africa, 15% of the population has hypertension while
6% of prevalence in Ethiopia [2].
• Non- adherence to medication has been the main causes
of failure in achieving blood pressure control [5]

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 Statement of the problem
• Analysis of the global burden of hypertension revealed
that over 25% of the world's adult population had
hypertension in 2000, and the proportion is expected to
increase to 29% by 2025 [2].
• A study reported, intensive versus standard BP control in
adults with hypertension results in 25% risk reduction in
major CV events and 27% reduction in all-cause
mortality [19].
• However, Uncontrolled hypertension increases the risk of
all-cause and cardiovascular disease mortality [21,22].

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• In general poor treatment control with long-term
medication and non lifestyle modification to
hypertension is a common problem that leads to
compromised health benefits and serious economic
consequences in terms of wasted time, money and
uncured disease [35].

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 Significance of the study
• Hypertension is public health problem both globally and
in our country
• Knowing prevalence of hypertension and factor leading
to poor BP control will be alarming for stakeholder to
take necessary action
• Further more, there is no sufficient study conducted in
the area, specifically in study area
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 Objectives
• GENERAL OBJECTIVE
– To assess magnitude of hypertension and factors associated with poor
treatment outcomes among hypertensive patients at Hiwot Fana and Jugol
Hospital, Harar Town, Eastern, Ethiopia from Feb. 18 to Apr. 18, 2021.

• Specific objectives
 To assess magnitude of hypertension.
 To identify Poor treatment outcome of hypertensive patients.

 To assess associated factors with Poor treatment outcome in

hypertensive patients.
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 Study area, period and design
STUDY AREA & PERIOD
 This study was conducted at Hiwot Fana
(HFUSH) and Jugol Hospital (JH),from February
18 – April 18 2021 G.C

STUDY DESIGN
The study will be conducted using hospital based
descriptive cross –sectional study

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 POPULATION

SOURCE POPULATION
– The source populations will be all patients visiting Hiwot Fana
andJugol Hospital and who were diagnosed to have HTN.

STUDY POPULATION
– All adult hypertensive patients attending the facility on out
patients at chronic case follow up clinic during the study
period and volunteered to take part in the study will be used
for the study

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 CRITERIA
INCLUSION CRITERIA
 Patients presented with a history of hypertension at OPD of
this hospital for at least six months duration and on
medication during the study period.
 Diabetic hypertensive patients is a part of the study proved
that they are on anti-hypertensive medication.
 Patients who are clinically stable.
 Patients who are mentally stable.

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 EXCLUSION CRITERIA

 Pregnancy induced hypertension patients.

 Hypertensive patients less than six month duration of
after diagnosis.
 Hypertensive urgency or emergency

 Patients with mental illnesses leading to confusion

were excluded from participating in the study, e.g.
delirium, dementia, psychosis, schizophrenia etc.

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 SAMPLE SIZE & SAMPLING TECHNIQUE
SAMPLE SIZE
–The sample size will be determined by using the following formula.

n= (zα\2)2 P (1-P)
d2

Where z stands for normal variable confidence interval 95%=1.96

p=prevalence (50%)
q=1-p=1-0.5=0.5
n=the desired sample size
d=the margin of sampling error (5%)
ni = (1.96)2 0.5(1-0.5) =384
(0.05)2


Systematic random sampling technique will be used to recruit the patients

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STUDY VARIABLES
Dependent Variables
• ü Prevalence of hypertension.

 Independent Variables
ü Demographic variables: age, sex, marital status, educational status, financial
support, social

support, occupation, residence, family history.

 Disease related variables: stage of hypertension, complications.

 Drug related variables: Duration of therapy, number of anti-hypertensive

drugs

ü Set up related variables: frequency of follow up visits, quality of medical

service

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 Data Collection Procedure and Data Quality
Control
• The data will be collected using a questionnaire consisting of
the 8- item morisky medication adherence scale self-reported
medication adherence questions relating to medication use
and major reasons for non-adherence
• The data will be collected by using interview technique
• The data will collected by the principal investigator. The tool
will be cross matched with available information on records;
• then the study questions rearranged as necessary. Incomplete
questioner will discarded

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 DATA PROCESSING AND ANALYSIS
• All the data collected will be analyzed SPSS and presented in the
form of frequency table, graphs &charts.
• A cut-off point will set at 4 and the respondents will categorized
in to adherent and non-adherent groups, based on the total score
of MMAS.
• The respondents with a score of below 4 will be considered as
adherent and a score of above 4 will be considered as non-
adherent.

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 ETHICAL CONSIDERATION
• First an official permission and formal letter will be received
from Harar Health Science Collage and will be sent to Hiwot
Fana and Jugol Hospital.
• Next, the reason why the data were collected from the patient
will be explained to them.
• After the patient understood, data collection will be proceeded
accordingly by keeping privacy and confidentiality .

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 OPERATIONAL DEFINITIONS

•Adherent: -Respondents who had scored below the

value expected to score in the study (scored a total
MMAS less than 4).
•Non adherent: - Respondents who had scored above
the value expected to score in the study (a total MMAS
score greater than or equals to 4).
•Sedentary: a lifestyle of not engaging in any physical

activity.

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 ACKNOWLEDGMENT
• First and Foremost we would like to thank Harar
Health Science College department of
Comprensive Nurse for giving us such chance to
change our theoretical knowledge to practical skill.
• We would also like to express our heart-felt thanks
to our advisors Mr. Abas.M and Mr.Yenebeb for
their unreserved encouragement, provision of
relevant and timely comments, information and
guidance throughout our proposal preparation.

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 Sample Reference
1. Abere D, et al: Adherence to antihypertensive treatment and associated factors among patients
on follow up at University of Gondar Hospital, Northwest Ethiopia. BMC Public Health2012;
12:282.
2. Roland N, Cyprian K: Assessment of patient’s antihypertensive medication adherence level in
non-co morbid hypertension in a tertiary hospital in Nigeria. Int J Pharm Biomed Sci2012, 3(2),
47-54.
19. Group SR. A randomized trial of intensive versus standard blood-pressure control. N Engl J
Med. 2015;373(22):2103–16.
21. Zhou D, Xi B, Zhao M, Wang L, Veeranki SP. Uncontrolled hypertension increases risk of all-
cause and cardiovascular disease mortality in US adults: the NHANES III linked mortality study.
Sci Rep. 2018;8(1):9418.
22. Lanti M, Puddu PE, Vagnarelli OT, Laurenzi M, Cirillo M, Mancini M, et al. Antihypertensive
treatment is not a risk factor for major cardiovascular events in the Gubbio residential cohort
study. J Hypertens. 2015;33(4):736–44.
23. Lemma, G.F.a.S., Socioeconomic Status and Hypertension among Teachers and Bankers in
Addis Ababa, Ethiopia. International Journal of Hypertension, 2016: p. 7.

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