Adherence to Antihypertensive Medication: An Interview Analysis of Southwest Ugandan Patients' Perspectives.
Journal
Annals of global health
ISSN: 2214-9996
Titre abrégé: Ann Glob Health
Pays: United States
ID NLM: 101620864
Informations de publication
Date de publication:
10 06 2020
10 06 2020
Historique:
entrez:
8
9
2020
pubmed:
9
9
2020
medline:
16
10
2021
Statut:
epublish
Résumé
Hypertension is a significant cardiovascular disease (CVD) and driver to CVD disorders in sub-Saharan Africa. It is a major independent risk factor for heart failure, stroke, and kidney failure. Persons living with hypertension attend to many aspects of self-care to manage their condition, including high blood pressure medication adherence to control of blood pressure. Rates of medication non-adherence, and thus uncontrolled hypertension, remain high and contribute to poor health outcomes. Understanding barriers and facilitators to adherence to hypertension therapies can help improve health outcomes. The aim of the study was to describe the common reasons for adherence and non-adherence to antihypertensive medication from patients' perspectives. A qualitative study engaged clients of an out-patient clinic of a regional referral hospital in southwestern Uganda who were living with hypertension as participants. One-on-one in-depth interviews provided the narrative data. The interview transcripts were analyzed using thematic analysis. Sixteen participants provided the data for the findings. The themes identified as facilitators for adherence to antihypertensive medication were patients' understanding of prescribed medication, availability of medication for hypertension, family support for patients living with hypertension, and regular review appointments at the hypertensive clinics. Conversely, lack of supply in government dispensaries, use of self-prescribed analgesic medication, and stigma were identified as barriers and challenges of adherence to antihypertensive medication. There is an urgent need for the health ministry to improve availability of high blood pressure medication and for health care providers to deliver individualized patient centered care, and sensitization on danger of self-prescription and measures that reduce stigma. These strategies may improve adherence to high blood pressure medication.
Sections du résumé
Background
Hypertension is a significant cardiovascular disease (CVD) and driver to CVD disorders in sub-Saharan Africa. It is a major independent risk factor for heart failure, stroke, and kidney failure. Persons living with hypertension attend to many aspects of self-care to manage their condition, including high blood pressure medication adherence to control of blood pressure. Rates of medication non-adherence, and thus uncontrolled hypertension, remain high and contribute to poor health outcomes. Understanding barriers and facilitators to adherence to hypertension therapies can help improve health outcomes.
Objective
The aim of the study was to describe the common reasons for adherence and non-adherence to antihypertensive medication from patients' perspectives.
Methods
A qualitative study engaged clients of an out-patient clinic of a regional referral hospital in southwestern Uganda who were living with hypertension as participants. One-on-one in-depth interviews provided the narrative data. The interview transcripts were analyzed using thematic analysis.
Findings
Sixteen participants provided the data for the findings. The themes identified as facilitators for adherence to antihypertensive medication were patients' understanding of prescribed medication, availability of medication for hypertension, family support for patients living with hypertension, and regular review appointments at the hypertensive clinics. Conversely, lack of supply in government dispensaries, use of self-prescribed analgesic medication, and stigma were identified as barriers and challenges of adherence to antihypertensive medication.
Conclusions
There is an urgent need for the health ministry to improve availability of high blood pressure medication and for health care providers to deliver individualized patient centered care, and sensitization on danger of self-prescription and measures that reduce stigma. These strategies may improve adherence to high blood pressure medication.
Identifiants
pubmed: 32897274
doi: 10.5334/aogh.2904
pmc: PMC7470164
doi:
Substances chimiques
Antihypertensive Agents
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
58Subventions
Organisme : FIC NIH HHS
ID : D43 TW010128
Pays : United States
Informations de copyright
Copyright: © 2020 The Author(s).
Déclaration de conflit d'intérêts
The authors have no competing interests to declare.
Références
Int J Health Policy Manag. 2019 Aug 01;8(10):593-606
pubmed: 31657186
Biotechnol Healthc. 2009 Jun;6(2):39-44
pubmed: 22478765
N Engl J Med. 2013 Sep 5;369(10):954-64
pubmed: 24004122
Eur Arch Psychiatry Clin Neurosci. 2018 Feb;268(1):27-38
pubmed: 28756468
J Clin Hypertens (Greenwich). 2016 Mar;18(3):207-16
pubmed: 26279168
PLoS One. 2015 Nov 11;10(11):e0142312
pubmed: 26560131
Lancet. 2012 Dec 15;380(9859):2224-60
pubmed: 23245609
PLoS One. 2016 Jul 01;11(7):e0158499
pubmed: 27367542
BMC Res Notes. 2017 Dec 04;10(1):675
pubmed: 29202881
Health Policy Plan. 2016 Mar 8;31(7):878-883
pubmed: 26962122
AIDS Patient Care STDS. 2015 Feb;29(2):86-94
pubmed: 25607900
Medicine (Baltimore). 2017 Jan;96(4):e5641
pubmed: 28121920
Intern Emerg Med. 2016 Apr;11(3):299-305
pubmed: 27001886
Br J Gen Pract. 2016 Nov;66(652):570
pubmed: 27789496
BMC Cardiovasc Disord. 2018 Jul 24;18(1):150
pubmed: 30041606
Ann Glob Health. 2019 Mar 05;85(1):
pubmed: 30873810
Circ Cardiovasc Qual Outcomes. 2017 Sep;10(9):
pubmed: 28830861
Int J Equity Health. 2010 Oct 13;9:23
pubmed: 20942899
Br Dent J. 2008 Apr 26;204(8):429-32
pubmed: 18438371
BMC Public Health. 2012 Apr 10;12:282
pubmed: 22490130
Hypertension. 2007 Dec;50(6):1012-8
pubmed: 17954720
Pan Afr Med J. 2017 May 01;27:1
pubmed: 28748003
Health Educ Behav. 2018 Jun;45(3):435-443
pubmed: 29025281
Ann Glob Health. 2020 Jan 14;86(1):5
pubmed: 31976304
BMC Cardiovasc Disord. 2013 Aug 02;13:54
pubmed: 23915151
Res Social Adm Pharm. 2018 May;14(5):413-417
pubmed: 28533081
AIDS Behav. 2017 Jan;21(1):238-247
pubmed: 26864692
Ann Med Health Sci Res. 2014 Nov;4(6):922-7
pubmed: 25506487
Am J Trop Med Hyg. 2018 Jan;98(1):262-265
pubmed: 29141744
J Am Pharm Assoc (2003). 2012 Sep-Oct;52(5):e122-9
pubmed: 23023858
PLoS One. 2019 Jul 10;14(7):e0219266
pubmed: 31291293
BMC Res Notes. 2016 Jan 02;9:3
pubmed: 26725042
Arch Public Health. 2014 Oct 27;72(1):37
pubmed: 25671110