factors affecting compliance to anti-hypertensive drug treatment and lifestyle modification among patients attending primary health care clinics in bethlehem

Antihypertensive treatment is an important challenge and public health issue, compliance to treatment of hypertension is one of the important factors that affect blood pressure control, no enough studies had been done about this issue in Palestine. In this study compliance to drug and lifestyle modification treatment were investigated. The aim of this study was to assess the factors affecting compliance to antihypertensive drug treatment and recommended lifestyle modifications among hypertensive Palestinian patients attending primary health care clinics in Bethlehem district. A descriptive cross sectional design was applied on systematic random sampling, sample of 300 hypertension participant at UNRWA, Government, and Non-Governmental clinic, using an interviewer administrated close ended questionnaire which depended on Health Belief Model. The questionnaires were filled face to face, the response rate was 100% in all clinics, Data analysis was done using (SPSS) version 19 to measure compliance on a 4- point Likert scale. The most important findings were (65.6%) of the participants were female, and (34.3%) were male, participants had a range age of (28-80). Among the total respondents (32.6%) didn’t had any complications, (67.1%) had one problems or more related to hypertension,the majority of the respondents took one to three medication (96%), ( 0.7%) didn't had any medications. (99.1%) took one to three doses of medication per day, (69.3%) of the total respondents didn't skip any dose and (30.7%) skipped one or more dose. And there was a strong significant association between doses skipped per day (p-value = 0.000) perception of severity (p-value = 0.003), perception of barriers (p-value = 0.000 and internal factors (p-value = 0.001) of total respondents and treatment compliance. ForUNRWA respondents there was significant relationship between gender (p-value =0.035), doses skipped in the last three days (p-value =0.035), perception of barriers (p-value =0.001), internal factors (p-value = 0.011) and treatment compliance. For the government respondents there was significant association between doses skipped in the last three days (p-value = 0.000) and body mass index (p-value = 0.013), perception of severity (p-value = 0.039), perception of barriers (p-value = 0.008), cues to action (p-value = 0.019) and treatment compliance. For the NGO there was association between educational status(pvalue = 0.037)and occupational status (p-value = 0.03), perception of barriers (p-value =0.024), internal factors(p-value = 0.008) and treatment compliance. The best predictor variables for treatment compliance were perception of barriers, perception of internal factors and perception of severity of total respondents. For UNRWA respondents the best predictor variables were perception of barriers and perception of internal factors. For Government respondents the best predictive variables were perception of barriers and cues to action. For NGOs the best predictive variables were internal factors and perception of barriers. This study concluded that the most important factors affected treatment compliance of therespondents were doses skipped, gender, body mass index, educational status, occupational status, perception of severity, perception of barriers, cues to action and internal factors. This study concluded that the total respondents were compliance to their drug treatment and lifestyle modification, NGOs respondent were more compliant than UNRWA and Government respondents in drug treatment while Government and UNRWA were more compliant than NGOs in lifestyle modification Key words: Compliance; hypertension; lifestyle modification; drug treatment