Using the Health Believe Model to Explain the Patient’s Compliance to Anti-hypertensive Treatment in Three District Hospitals - Dar Es Salaam, Tanzania: A Cross Section Study

Abstract Background Hypertension is one of the most important cardiovascular risk factors; but compliance to anti-hypertensive medications remains to be a public health challenge worldwide. Health belief model have been used to explain adoption of preventive measures to health problems. This study used the health belief model as a framework to explain the compliance to anti-hypertensive drugs among elderly hypertensive patients. The study aimed at finding the influence of health belief model in treatment compliance among elderly hypertensive patients in three district hospitals in Dar es Salaam, Tanzania. Methods We conducted an analytical cross- sectional study in three District hospitals in Dar es Salaam Region. We included patients who were on antihypertensive medications. Simple random sampling was used to enrol study participants. Data were collected using structured questionnaires. Data were analysed using SPSS. Frequency distribution and Multivariate analysis was done using Linear Multiple Regression to identify variables which are strongest predictor of treatment compliance among variables of Health Believe Model. Results: A total of 135 participants were enrolled, 56% were compliant to treatment. Multiple linear regression was used to operationalize the Health Belief Model with treatment compliance being dependant variable. The predictor variables were perceived benefit, perceived barriers and cues to action. Multivariate analysis indicated significant model fit for the data (F = 11.19 and P value < 0.001). The amount of variance in treatment compliance that is explained by the predictors is 30.3% (R² = 0.303) with perceived barrier being the strongest predictor of treatment compliance (β = -0.477; p < 0.001). A negative beta coefficient indicates a negative association between perceived barriers and treatment compliance. Other predictor variables were not statistically associated with treatment compliance. Conclusion: The study showed that almost half of study participants had hypertensive treatment compliance, with the use of health believe model the important strongest variable was perceived barrier to treatment. An innovative strategy on improving patients’ perception of barrier to treatment is recommended to increase treatment compliance. Key words: Hypertension, Treatment compliance, lifestyle