A Qualitative Study on Barriers to Treatment and Control of Hypertension Among Patients at Dessie Referral Hospital, Northeast Ethiopia, Ethiopia: Healthcare Workers’ Perspective

Abstract

Introduction Hypertension is the leading cause of morbidity and mortality and accounts for 13% of all deaths and 7% of the disease burden in the world. Although the importance of controlling hypertension has been recognized for many years, the majority of patients with hypertension remain uncontrolled. Studies indicate a very low adherence to lifestyle modifications among patients in the study area. Hypertensive patients face set of problems associated with adherence to antihypertensive drugs and healthy lifestyle modifications. Objective The objective of the study was to explore barriers to hypertension treatment and control from healthcare workers’ perspective and experiences at Dessie Referral Hospital, Ethiopia. Methods Seven healthcare workers actively involved in managing hypertensive individuals at Dessie Referral Hospital were recruited for the study. Participants were purposively selected from outpatient, inpatient, and pharmacy departments. The required data were collected by the principal investigator on exit interviews. An interview guide was developed by reviewing previous literature. Interviews were semi-structured, 8–20 minutes in duration, and designed to elicit healthcare workers’experiences and perceptions and conducted until data saturation was reached. All interviews were recorded, transcribed verbatim, and thematically analyzed. Each theme was supported by using the participants’ quotes. Results Three themes emerged. The major barriers impacted patients’ medication adherence and healthy lifestyle modifications were common use of diets during social settings, low level of awareness, lack of resources, misconceptions about hypertension, use of traditional medicines, inadequate physical activities, and high cost of drugs. Conclusion Patients’ misconceptions about hypertension, common use of diets during festivals, and inadequate physical activities were factors associated with inadequate blood pressure control. Healthcare workers should better understand the problems that hypertensive patients’ face, thus achieving better control.

Outcomes and Challenges in Noncommunicable Disease Care Provision in Health Facilities Supported by Primary Health Care System Strengthening Project in Sri Lanka: A Mixed-Methods Study

“…This mirrors findings from other studies in similar settings [47,49,50]. As reported elsewhere, this could be because patients were not compliant with prescribed medications and lifestyle modifications, as mentioned by HCWs [55,56]. Additionally, not all the NCD drugs were available, requiring patients to purchase these from the private pharmacies.…”

Facilitators and barriers to hypertension management in urban Nepal: findings from a qualitative study

“…We found that the individuals with adequate knowledge on hypertension were motivated to adopt healthy lifestyles and adhere to medication, which is also reported by previous studies from Nepal 27 28 and LMICs. [29][30][31][32][33] Consistent with findings from previous studies, motivation to adopt healthy lifestyles waned after starting medication in part due to insufficient knowledge about treatment measures. 27 30 31 34 Patients and families could benefit from understanding the value of antihypertensive medication, and medication in tandem with lifestyle measures giving the best health benefit.…”

“…Our results provide insights which can be applied globally. Research from other LMICs also show that adequate knowledge on hypertension services motivates patients to adopt treatment measures, [30][31][32][33] and that addressing misconceptions 29 46 and continued family support 34 49 contribute to sustained behavioural changes. Rebuilding trust in primary healthcare providers 34 49 55 is critical to ensure access to services for marginalised communities.…”