{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:31:11Z","timestamp":1777883471050,"version":"3.51.4"},"reference-count":52,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Chronic Disease"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Hypertension (HTN) is a leading lifestyle disease and a major cause of morbidity and mortality worldwide, especially in sub-Saharan Africa. Clinical practice guidelines (CPGs) serve as useful tools for clinical decision-making by leading clinicians to measure appropriateness and ultimately measure the quality of care and reduce clinical inertia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to assess prescribers\u2019 awareness, adherence to CPGs, barriers to it, and its associated factors among prescribers working at public hospitals in Northwest Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A multicenter explanatory sequential mixed-methods study was conducted between October 01, 2023 and January 30, 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      STATA version 17.0 was used for analysis, following entry of data into EpiData (version 4.6.0.0). Adherence of prescribers to HTN CPGs was determined using the scoring system results of the JNC 7 adherence scale. Associations between variables were assessed by the Chi-square (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      ) test. An adjusted odds ratio (AOR) with 95% CI with a\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value &lt;0.05 was considered statistically significant in multivariable logistic regression analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In the present study, out of 403 prescribers approached, 370 completed the interview, resulting in a response rate of 91.8%. Most of the prescribers (90.5%) were aware of HTN CPGs. More than one-third (41.1%) of the prescribers were low adherent to the HTN CPGs. Prescribers with 1\u20135\u2009years (AOR\u2009=\u20093.22, 95% CI\u2009=\u20091.27\u20138.15) and 6\u201310\u2009years (AOR\u2009=\u20094.59, 95% CI\u2009=\u20091.62\u201311.05) of experience; the availability of resource in the hospital (AOR\u2009=\u20091.78, 95% CI\u2009=\u20091.11\u20132.87), and qualification, with general practitioners (AOR\u2009=\u20092.98, 95% CI\u2009=\u20091.46\u20136.10) and nurses (BSc and above) (AOR\u2009=\u20097.29, 95% CI\u2009=\u20093.55\u201310.91) were significantly associated with high adherence to CPGs. The qualitative part of the study identified barriers to HTN CPGs, including limited resources, patient influence, and complexity of the guidelines. Participants recommended improving access, updating and simplifying CPGs, and enhancing institutional support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>More than one-third of the prescribers were low adherent to CPGs. Continuous training and education in terms of using evidence-based therapeutic guidelines is crucial in patient care and reduces clinical inertia. To promote excellence in clinical practice, concerted efforts are needed to promote application of evidence-based HTN treatment guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/27558428261420524","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T10:47:50Z","timestamp":1773917270000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prescribers\u2019 adherence to clinical practice guidelines for the management of hypertension at public hospitals in Northwest Ethiopia: An explanatory sequential mixed-methods study"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6813-8792","authenticated-orcid":false,"given":"Tilaye Arega","family":"Moges","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8938-4551","authenticated-orcid":false,"given":"Samuel","family":"Berihun Dagnew","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2616-4014","authenticated-orcid":false,"given":"Woretaw Sisay","family":"Zewdu","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel Agegnew","family":"Wondm","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8678-6723","authenticated-orcid":false,"given":"Getachew Yitayew","family":"Tarekegn","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9361-1033","authenticated-orcid":false,"given":"Desalegn Addis","family":"Mussie","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teklie Mengie","family":"Ayele","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2945-0306","authenticated-orcid":false,"given":"Sisay Sitotaw","family":"Anberbr","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bayih Endalew","family":"Bitew","sequence":"additional","affiliation":[{"name":"Department of Social and Administrative, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abraham Nigussie","family":"Assefa","sequence":"additional","affiliation":[{"name":"Department of Social and Administrative, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Addisu Assfaw","family":"Ayen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3309-9102","authenticated-orcid":false,"given":"Fisseha Nigussie","family":"Dagnew","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31919-5"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.5830\/CVJA-2017-040"},{"issue":"4","key":"e_1_3_3_4_2","first-page":"152","article-title":"Hypertension in sub-Saharan Africa: a massive and increasing health disaster awaiting solution","volume":"26","author":"Campbell NR","year":"2015","unstructured":"Campbell NR, Lemogoum D. Hypertension in sub-Saharan Africa: a massive and increasing health disaster awaiting solution. Cardiovasc J Afr 2015; 26(4): 152\u2013154.","journal-title":"Cardiovasc J Afr"},{"key":"e_1_3_3_5_2","first-page":"38","volume-title":"Pan Afr Med J","volume":"16","author":"de Vijver SV","year":"2013","unstructured":"de Vijver SV, Akinyi H, Oti S, et al. Status report on hypertension in Africa-Consultative review for the 6th Session of the African Union Conference of Ministers of Health on NCD\u2019s. Pan Afr Med J 2013; 16: 38."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.284427"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.13.124495"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61766-8"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.4102\/curationis.v40i1.1679"},{"issue":"6","key":"e_1_3_3_10_2","first-page":"1","article-title":"Prevalence and awareness of hypertension among Sudanese rural population, Sinnar state, Sudan, 2016","volume":"7","author":"Elfaki BA","year":"2017","unstructured":"Elfaki BA, Mustafa HE, Elnimeiri MK. Prevalence and awareness of hypertension among Sudanese rural population, Sinnar state, Sudan, 2016. J Nurs Educ Pract 2017; 7(6): 1.","journal-title":"J Nurs Educ Pract"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.19082\/1796"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/jphsr\/rmaa017"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30374-2"},{"issue":"6","key":"e_1_3_3_14_2","first-page":"53","article-title":"Lost in translation: the acute care nurse practitioners\u2019 use of evidence based practice: a qualitative study","volume":"4","author":"Branham S","year":"2014","unstructured":"Branham S, DelloSritto R, Hilliard T. Lost in translation: the acute care nurse practitioners\u2019 use of evidence based practice: a qualitative study. J Nurs Educ Pract 2014; 4(6): 53.","journal-title":"J Nurs Educ Pract"},{"key":"e_1_3_3_15_2","volume-title":"Clinical practice guidelines we can trust","author":"Steinberg E","year":"2011","unstructured":"Steinberg E, Greenfield S, Wolman DM, et al. Clinical practice guidelines we can trust. National Academies Press, 2011."},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7182.527"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2017.01.001"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.4103\/2249-4863.197317"},{"issue":"7","key":"e_1_3_3_19_2","first-page":"503","article-title":"JNC8 guidelines for the management of hypertension in adults","volume":"90","author":"Armstrong C.","year":"2014","unstructured":"Armstrong C. JNC8 guidelines for the management of hypertension in adults. Am Fam Physician 2014; 90(7): 503\u2013504.","journal-title":"Am Fam Physician"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2261-9-39"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.4102\/phcfm.v7i1.776"},{"issue":"1417","key":"e_1_3_3_22_2","first-page":"41","article-title":"Clinical governance and point-of-care testing at health provider level","volume":"128","author":"Herd G","year":"2015","unstructured":"Herd G, Musaad SM. Clinical governance and point-of-care testing at health provider level. N Z Med J 2015; 128(1417): 41\u201346.","journal-title":"N Z Med J"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.4324\/9780429297021-19"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4140-z"},{"key":"e_1_3_3_25_2","unstructured":"EFDA. Pharmaceutical Products Traceability Master Data Guideline. March 2021."},{"key":"e_1_3_3_26_2","author":"Federal Democratic Republic of Ethiopia","year":"2021","unstructured":"Federal Democratic Republic of Ethiopia. Standard treatment guidelines for general hospital. 4th ed. 2021.","journal-title":"Standard treatment guidelines for general hospital"},{"key":"e_1_3_3_27_2","unstructured":"Federal Democratic Republic of Ethiopia. Guidelines on Clinical and Programmatic Management of Major Non Communicable Diseases 2016."},{"key":"e_1_3_3_28_2","unstructured":"Scotland HI. Clinical governance and risk management\u2013national standards http:\/\/www.healthcareimprovementscotland.org\/previous_resources\/standards\/clinical_governance_and_risk_m.aspx (2022 accessed 22 October 2022)."},{"issue":"1434","key":"e_1_3_3_29_2","first-page":"9","article-title":"The New Zealand Rural Hospital Doctors Workforce Survey 2015","volume":"129","author":"Lawrenson R","year":"2016","unstructured":"Lawrenson R, Reid J, Nixon G, et al. The New Zealand Rural Hospital Doctors Workforce Survey 2015. N Z Med J 2016; 129(1434): 9\u201316.","journal-title":"N Z Med J"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006157"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.081232"},{"key":"e_1_3_3_32_2","unstructured":"Webster M. Dictionary Merriam Webster http:\/\/www.merriamwebster.com\/dictionary\/creativity (2015): 4231\u20134245."},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jhh.1002005"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2019.05.003"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.5001\/omj.2023.84"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2016.84"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"issue":"1","key":"e_1_3_3_38_2","first-page":"68","article-title":"ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/nma\/pcna guideline for the prevention, Detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American heart Association Task Force on Clinical Practice Guidelines","volume":"7","author":"Whelton PK","year":"2018","unstructured":"Whelton PK, Carey RM, Aronow WS. ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/nma\/pcna guideline for the prevention, Detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018; 7(1): 68\u201374.","journal-title":"J Am Coll Cardiol"},{"key":"e_1_3_3_39_2","first-page":"21","article-title":"Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at Jimma University Teaching and Specialized Hospital: cross-sectional study","volume":"2017","author":"Tesfaye B","unstructured":"Tesfaye B, Haile D, Lake B, et al. Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at Jimma University Teaching and Specialized Hospital: cross-sectional study. Res Rep Clin Cardiol 2017: 21\u201329.","journal-title":"Res Rep Clin Cardiol"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.7326\/M17-3203"},{"issue":"1","key":"e_1_3_3_41_2","first-page":"503821","article-title":"Physicians\u2019 perceptions and adherence to guidelines for the management of hypertension: a national, multicentre, prospective study","volume":"2012","author":"Theodorou M","year":"2012","unstructured":"Theodorou M, Stafylas P, Kourlaba G, et al. Physicians\u2019 perceptions and adherence to guidelines for the management of hypertension: a national, multicentre, prospective study. Int J Hypertens 2012; 2012(1): 503821.","journal-title":"Int J Hypertens"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0273439"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-6175.2007.06112.x"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-015379"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-12-455"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-006-0075-2"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-4-54"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20130147"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.4172\/pharmaceutical-sciences.1000309"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.51972\/tfsd.892363"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.28982\/josam.819228"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1137706"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2022.106557"}],"container-title":["Sage Open Chronic Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/27558428261420524","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/27558428261420524","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/27558428261420524","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:46:53Z","timestamp":1777600013000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/27558428261420524"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":52,"alternative-id":["10.1177\/27558428261420524"],"URL":"https:\/\/doi.org\/10.1177\/27558428261420524","relation":{},"ISSN":["2755-8428","2978-1558"],"issn-type":[{"value":"2755-8428","type":"print"},{"value":"2978-1558","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"article-number":"27558428261420524"}}