HIV- and hypertension-related knowledge and medication adherence in HIV seropositive persons with hypertension

Abstract

Background There is increasing prevalence of diseases associated with ageing such as hypertension, among people living with HIV (PLWHV). This study sought to assess: (1) knowledge related to HIV infection and hypertension, (2) adherence to prescribed medications and (3) clinical outcomes among HIV-positive persons with hypertension at a Nigerian hospital. Methods The Patient’s HIV Knowledge Questionnaire (PHKQ), Hypertension Knowledge-Level Scale (HK-LS) and Adherence to Refills and Medication Scale (ARMS) were administered to 220 eligible patients through the HIV clinic. Demographic and clinical data were also obtained. Results Participants were predominantly females (57.3%), with a median (IQR) age of 46 (38–58) years; majority were married (67.8%) and employed (60.8%). Participants reported a higher hypertension-related knowledge compared with HIV-related knowledge (63.6% versus 33.3%, Z = −10.263, P < 0.001), but better adherence to antiretroviral medications compared to antihypertensives (100.0% versus 89.3%, Z = −9.118, P < 0.001). Of the 98 participants with documented viral load, 55 (56.1%) had undetectable (<40 copies/ml) values; however, only four (2.0%) of the entire sample had controlled (<140/90 mmHg) blood pressure. Conclusions Despite having a higher hypertension-related knowledge, adherence to antihypertensive medications and blood pressure control were poor. There is a need for increased attention to HIV education and comorbidities in PLWHV.

Intervention strategies to improve adherence to treatment for selected chronic conditions in sub‐Saharan Africa: a systematic review

“…The reasons for the exclusion of papers are noted in Figure 1. In total, 82 articles [27–108] were found to be eligible and data were then extracted (Supplementary Material 4).…”

“…The reasons for the exclusion of papers are noted in Figure 1 . In total, 82 articles [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 ,…”

Clinical outcomes of pharmaceutical care intervention in HIV positive patients with hypertension: A randomized controlled study

“…In spite of this, data suggest that hypertensive PLWHV receive sub‐optimal hypertension care 10 . Moreover, although PLWHV have regular and routine access to health care, several studies have shown that rates of BP control are low in those with coexisting hypertension, 11–15 indicating possible one‐dimensional focus of care in HIV clinics 10…”

“…An important cause of poor BP control is poor adherence to antihypertensive drugs 16 which could be due to a myriad of reasons. In PLWHV, management of comorbidities is often relegated 17 ; antiretroviral medications are usually regarded as being more important than medications for hypertension, resulting in better adherence to the former 12,18,19 . Furthermore, the potential for drug‐drug interaction is higher in multimorbidity 20,21 ; such interactions have been adduced to explain clinical failure of antiretroviral therapy 21 .…”

“…Through PC, the pharmacist is able to improve health outcomes by reinforcing messages regarding the importance of achieving treatment goals, education about drug therapies, effective lifestyle modifications and treatment adherence 7 . Previous studies have focused on PC in either HIV 24–26 or hypertension, 27,28 or assessed differential clinical outcomes in HIV‐hypertension comorbidity 12,17,18,29,30 . However, none, to the best of our knowledge has evaluated the impact of PC in such comorbidity.…”