Adherence to medications, lifestyle advice, and self-monitoring for type 2 diabetes and hypertension in sub-Saharan Africa: A systematic review, meta-analysis, and interactive network analysis

Type 2 diabetes and hypertension pose significant public health challenges in sub-Saharan Africa, with poor treatment control. Adherence to essential treatment aspects—medication, lifestyle advice, and self-monitoring—is crucial for effective management but has not been systematically examined before. To address this gap, a team of researchers conducted a comprehensive systematic review and meta-analysis of adherence to key treatment pillars in sub-Saharan Africa.

The study analyzed 312 observational and interventional studies involving 108,014 participants from 28 countries across the continent. The results reveal that adherence to antidiabetic medications was 67% (95% CI [60, 73]), while adherence to antihypertensive medications stood at 51% (95% CI [44, 58]). Dietary recommendations garnered a 44% adherence rate (95% CI [38, 49]), physical activity monitoring achieved 42% (95% CI [37, 47]), and alcohol abstinence and smoking cessation boasted the highest adherence rates of 85% (95% CI [82, 88]) and 95% (95% CI [94, 96]), respectively.

However, self-monitoring of blood glucose was only observed in 18% (95% CI [12, 27]) of cases, and blood pressure monitoring lagged behind at 28% (95% CI [16, 45]). Overall, self-care adherence for type 2 diabetes and hypertension combined was found to be 37% (95% CI [30, 46]). The study underscores the need for targeted interventions focusing on education, self-efficacy, and social support to enhance adherence to treatment across all these crucial pillars.