Herbal and Alternative Medicine Use in Tanzanian Adults Admitted with Hypertension-Related Diseases: A Mixed-Methods Study
Table 4
Factors associated with medication nonadherence by ordered logistic regression in 213 consecutive adults hospitalized to Bugando Medical Centre with hypertension-related diseases.
Variable
High adherence (MMAS; 0) (%)
Medium adherence (MMAS; 1-2) (%)
Low adherence (MMAS; 3-4) (%)
Odds ratio 95% CI
value
Proportion (%)
Median
Female gender
23 (28.1)
16 (19.5)
43 (52.4)
0.74 [0.41–1.34]
0.31
Age category
≤45
12 (33.3)
9 (25.0)
15 (41.7)
46–55
4 (12.9)
10 (32.3)
17 (54.8)
56–65
11 (25.0)
7 (15.9)
26 (59.1)
>65
8 (16.7)
12 (25.0)
28 (58.3)
1.24 [0.95–1.62]
0.12
Education level
Not completed primary school
5 (11.9)
9 (21.4)
28 (66.7)
Completed primary school
25 (27.5)
18 (19.8)
48 (52.8)
Completed secondary school
5 (19.2)
11 (42.3)
10 (38.5)
0.63 [0.40–0.99]
0.04
Occupation
Farmer
14 (25.9)
9 (16.7)
31 (57.4)
Small scale business
5 (14.3)
10 (28.6)
20 (57.1)
Professional, business, or student
16 (22.9)
19 (27.1)
35 (50.0)
1.20 [0.53–2.74]
0.68
No insurance
21 (21.2)
22 (22.2)
56 (56.6)
0.80 [0.44–1.48]
0.47
Systolic blood pressure
≤140
8 (20.5)
14 (35.9)
17 (43.6)
141–160
9 (20.5)
7 (15.9)
28 (63.6)
1.78 [0.78–4.08]
161–180
7 (20.0)
8 (22.9)
20 (57.1)
1.45 [0.62–3.42]
>180
11 (26.8)
9 (22.0)
21 (51.2)
1.09 [0.48–2.45]
0.51
Is hypertension curable (or is it a lifelong condition)?
No (hypertension is a lifelong condition)
23 (28.8)
25 (31.3)
32 (40.0)
Yes (hypertension is curable)
12 (15.2)
13 (16.5)
54 (68.4)
0.34 [0.18–0.63]
0.001
Is there anything that can be done to prevent hypertension?
Yes
6 (12.8)
15 (31.9)
26 (55.3)
No
29 (25.9)
23 (20.5)
60 (53.6)
1.30 [0.68–2.49]
0.43
Years of diagnosis
1
12 (24.0)
10 (20)
28 (56.0)
≥2
8 (19.1)
12 (28.6)
22 (52.4)
≥5
8 (28.6)
4 (14.3)
16 (57.1)
≥10
7 (18.0)
12 (30.8)
20 (51.3)
0.99 [0.77–1.28]
0.93
Place of diagnosis
Hospital
35 (24.8)
34 (24.1)
72 (51.1)
Other
0
4 (22.2)
14 (77.8)
3.80 [1.21–11.85]
0.02
Ever used herbs for hypertension
14 (20.6)
19 (27.9)
35 (51.5)
0.92 [0.50–1.67]
0.77
Ever used herbs for any reason
24 (20.7)
33 (28.5)
59 (50.9)
1.32 [0.72–2.67]
0.44
Ever attended traditional healer
24 (22.6)
28 (26.4)
54 (50.9)
1.36 [0.72–2.60]
0.35
Stopped allopathic medications for herbal medicine
7 (20.6)
6 (17.7)
21 (61.8)
0.72 [0.34–1.54]
0.40
Concurrent use of allopathic medications and herbal medicine
8 (21.1)
8 (21.1)
22 (57.9)
0.85 [0.42–1.72]
0.64
Believes it is okay to use herbal medicines with allopathic medicines
26 (2.6)
27 (23.5)
62 (53.9)
1.06 [0.54–2.05]
0.87
Prevalence of comorbid conditions
30 (22.2)
34 (25.2)
71 (52.6)
−0.33 [−1.20–0.55]
0.46
Individual comorbid conditions
Diabetes mellitus
5 (15.2)
13 (39.4)
15 (45.5)
−0.14 [−0.4–0.56]
0.67
Kidney disease
6 (33.3)
1 (5.6)
11 (61.1)
0.01 [−0.1–1.02]
0.98
Stroke
2 (10.5)
5 (26.3)
12 (63.16)
0.52 [−0.43–0.47]
0.29
Heart failure
10 (21.3)
10 (21.3)
27 (57.5)
0.17 [−0.49–0.83]
0.61
MMAS-4 refers to Morisky Medication Adherence Scale, the 4-item scale; IQR, interquartile range; CI, confidence interval.
