No abstract

Hypertension and diabetes are major risk factors for cardiovascular diseases and optimal control of blood pressure (BP) and blood glucose are associated with reduced cardiovascular disease events. This study, therefore, sought to estimate the prevalence and associated factors of controlled BP and blood glucose levels among patients diagnosed with both hypertension and Type 2- diabetes mellitus (T2DM). A quantitative cross-sectional study was conducted in a primary health setting in Ghana among patients 18 years and older diagnosed with both hypertension and T2DM. Pearson’s chi-square was used to assess the association between BP and blood glucose levels and the independent variables. The multivariable binary logistic regression model was used to assess the adjusted odds of controlled BP and blood glucose levels. Among the 329 participants diagnosed with both hypertension and T2DM, 41.3% (95% CI: 36.1–46.8%) had controlled BP, 57.1% (95% CI: 51.7–62.4%) had controlled blood glucose whilst 21.8% (95% CI: 17.7–26.7%) had both controlled BP and blood glucose levels. Increased age, non-formal education, non-married, employed, single-dose anti-hypertensives or anti-diabetic medications, and hyperlipidaemia or stroke co-morbidities were positively associated with controlled BP levels. Being female, married, taking 2 or more anti-hypertensive medications, and moderate to high medication-related burden were positively associated with controlled blood glucose levels. In terms of both controlled BP and blood glucose levels, being employed, reduced income level, being registered with national health insurance, single anti-diabetes or anti-hypertensive medications, hyperlipidaemia or stroke co-morbidities, and moderate to high medication-related burden were positively associated with having both controlled BP and blood glucose levels. One in five patients with hypertension and T2DM had both BP and blood glucose levels under control. The benefits and risks of blood pressure and blood glucose targets should thus be factored into the management of patients with hypertension and T2DM.

Patients with hypertension and diabetes co-morbidity may have medication knowledge and therapy challenges that could impact on patients' outcomes. The study examines knowledge of medication and therapy among hypertension and Type-2-diabetes mellitus co-morbid patients at a Municipal hospital in Ghana. This study was conducted at the medical outpatient department (OPD) of the Municipal Hospital in Tema (a Harbour City), in the Greater Accra Region of Ghana. This was a prospective study involving 389 patients, who had co-morbid hypertension and Type-2-diabetes mellitus visiting an OPD of the hospital, of which 338 patients consented to be part of the study. The patients were interviewed with a semi-structured questionnaire, on the name, purpose, number of medications taken, dose, duration of therapy, mode of administration, and side effects of the medication therapy. Bloom's cut off was used to assess the overall patients' knowledge, and chi-square analysis used to test the association between knowledge and other variables. From the study, 29% of the study subjects (n=98) had five medicines prescribed (the highest) and three patients (0.9%) were prescribed nine medicines (the least). Patients had knowledge of the names of medication (n=158, 46.8%), duration of therapy (n=322, 95.3%), route of administration (n=324, 95.9%), purpose of anti-hypertensive (n=254, 75.1%), anti-diabetic therapy (n=251, 74.9%) and common side effects (n=50, 14.8%). Overall, more than half had inadequate knowledge of their medication and therapy (n=187, 55.3%). The hypertensive and diabetic patients did not have adequate knowledge about their medications and therapy. This provides justification for the integration of effective pharmaceutical care interventions to improve patients' outcomes.