Knowledge of disease condition and medications among hypertension patients in Lesotho

Mugomeri, Eltony; Ramathebane, Maseabata; Maja, Lineo; Chatanga, Peter; Moletsane, Lipalesa

doi:10.1016/j.jash.2015.10.009

Cited by 5 publications

(8 citation statements)

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“…Before-and-after studies as well as estimates from systematic reviews also show significant increases in the prevalence of hypertension in the same rural or urban populations over time in Africa [ 4 – 6 ]. Important features of hypertension in Africa include young age of onset of complications [ 7 ], high prevalence of target organ damage [ 8 – 11 ], poor knowledge about the disease in the general population and among hypertensive persons [ 12 , 13 ], use of alternative therapy [ 14 , 15 ], low levels of detection and control [ 16 – 18 ] and clustering of risk factors [ 19 ] and co-morbidities [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence, awareness, and associated risk factors of hypertension in older adults in Africa: a systematic review and meta-analysis protocol

et al. 2017

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BackgroundThe health of older persons has not been a major priority in many African countries. Hypertension is one of the common health problems of older persons. However, there is little information on the prevalence of hypertension in older adults in Africa. This is in spite of the fact that Africa has the highest age-standardized prevalence of hypertension in the world. We therefore present this protocol to conduct a systematic review and meta-analysis on the prevalence of hypertension and the level of its awareness among older persons living in Africa.MethodsMajor databases (EMBASE, MEDLINE, Academic Search Complete, CINAHL, PsycINFO) and unpublished literature will be searched to identify population-based studies on hypertension in adults aged 50 years and older living in Africa. Eligible articles are those which use the 140/90-mmHg cutoff to diagnose hypertension and were published from 1980 to present. We will exclude subjects in restricted environments such as patients and refugees. Articles will be independently evaluated by two reviewers to determine if they meet the inclusion criteria. They will also evaluate the quality of included studies using a validated tool by Hoy and colleagues for prevalence studies. The main outcome is the prevalence of hypertension while the explanatory variables include demographic, socio-economic, dietary, lifestyle and behavioural factors. Effect sizes in bivariate and multivariate analyses will be presented as odds or prevalence ratios. We will explore for heterogeneity of the standard errors across the studies, and if appropriate, we will perform a meta-analysis using a random-effects model to present a summary estimate of the prevalence of hypertension in this population.DiscussionThe estimates of the prevalence, the risk factors and the level of awareness of hypertension could help in galvanizing efforts at prioritizing the cardiovascular health of older persons in Africa.Systematic review registrationPROSPERO CRD42017056474 Electronic supplementary materialThe online version of this article (10.1186/s13643-017-0585-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Prevalence, awareness, and associated risk factors of hypertension in older adults in Africa: a systematic review and meta-analysis protocol

et al. 2017

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“…Mendis et al [30] emphasizes the need to scale up patient education to improve the patients' levels of health literacy about their NCDs and their respective treatments. Mugomeri et al [8] and Kilic et al [31] also corroborate this need in Lesotho.…”

Section: Overview Of the Resultsmentioning

confidence: 82%

“…This proportion implies that a significant number of patients need to be screened for NCDs during their monthly visits at the ART centers. Mugomeri et al [8] note that late diagnosis of NCDs increases the occurrence of complications, including organ damage, stroke, heart failure, or renal failure. Therefore, further studies to determine the prevalence of NCDs in people living with HIV are required in this population.…”

Section: Overview Of the Resultsmentioning

confidence: 99%

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The occurrence and quality of care of non-communicable diseases in people living with HIV in Maseru, Lesotho: a mixed-methods study

Mugomeri¹,

Khama²,

Seshea³

et al. 2017

HIV & AIDS Review

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Introduction: Chronic non-communicable diseases (NCDs) constitute a health problem worldwide. This problem is particularly important in people living with human immunodeficiency virus (PLHIV) in sub-Saharan countries where the prevalence of NCDs is expected to increase due to the epidemiological transition of life spans for PLHIV as treatment outcomes for HIV continue to improve. This study is the first to assess the occurrence and quality of care (QoC) of NCDs in PLHIV and to identify the contextual issues underpinning the QoC in Lesotho -a sub-Saharan country with the second highest prevalence of HIV globally.

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“…A study assessing adherence to anti-hypertensive therapy among 395 patients in the Democratic Republic of Congo found that poor knowledge of complications and a lack of education to hypertensive patients was significantly associated with nonadherence [10], while in Ethiopia and Algeria, a positive association has been reported between knowledge about hypertension, its treatment and complications, and good adherence [11,12]. Furthermore, In Lesotho and Zimbabwe, inadequate knowledge of hypertension was significantly associated with uncontrolled hypertension [13,14]. Consequently, health education comprises a critical recommendation to improving adherence to medicines in a broad range of diseases, and as such its importance should not be undercut by the findings of this study [15].…”

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confidence: 99%

Find and Plug the Leak: Improving Adherence to Anti-Hypertensive Medicines

Njuguna

Vedanthan

2017

Cardiovasc Drugs Ther

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Elevated blood pressure is the leading preventable cause of cardiovascular disease (CVD) death and disability globally [1,2]. Adherence to anti-hypertensive medicines is the cornerstone to blood pressure control and subsequent reductions in CVD related death and disability [3]. However, adherence to anti-hypertensive medicines remains suboptimal globally and in sub-Saharan Africa (SSA). A recent systematic review estimated rates of non-adherence to be 45% globally, rising to 63% among African and Asian populations [4]. Furthermore, non-adherence was noted in 84% of patients with uncontrolled hypertension. Hypertension prevalence is highest in Africa (46%) compared to other regions and is expected to increase by more than 65% by 2025 [5,6]. Consequently, there is an urgent need to implement strategies to monitor and improve adherence to anti-hypertensive medicines in SSA.Chronic care delivery for hypertension and other noncommunicable diseases (NCDs) remains elusive to a majority of SSA countries where health systems have being designed primarily to address acute infective diseases, maternal and child health, and the HIV epidemic [7]. Where hypertension care is available, socio-economic barriers associated with receiving chronic care limit access and utilisation by patients, with a significant impact on decreasing adherence to medicines [8]. In recognition of this key barrier, some SSA countries have built universal healthcare delivery platforms that provide free or subsidised hypertension care and medicines to their population. However, even in these areas, adherence remains sub-optimal.In Namibia, where universal care for hypertension is provided through public health care (PHC) facilities, Nashilongo et al. assessed the levels and predictors of adherence to antihypertensive medication, and validated a modified version of the Hill-Bone scale for compliance [9]. Their study recruited 120 patients regularly receiving medication refills for hypertensive drugs in four semi-urban PHC facilities in Windhoek. The primary outcome measure was the proportion of patients with ≥80% adherence on the Hill-Bone compliance scale, predefined as acceptable adherence.The modified Hill-Bone Scale for compliance had reasonable internal consistency and construct validity for assessing adherence in this population. Mean adherence level was 77% which was lower than the pre-specified ≥80% level designating good adherence. 58% of patients had adherence levels ≤80%. Independent predictors of good adherence after multivariable logistical regression were having a treatment support buddy, never having missed a clinic appointment, and always attending follow-up visits. Although age and distance to the PHC facility were associated with good adherence on bivariate analysis, these associations were not sustained in the multivariable model. Finally, no association was found between sex, employment status, education level, presence of a comorbidity, and knowledge on hypertension medicines or complications with adherence.Several limitations of thi...

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Knowledge of disease condition and medications among hypertension patients in Lesotho

Cited by 5 publications

References 20 publications

Prevalence, awareness, and associated risk factors of hypertension in older adults in Africa: a systematic review and meta-analysis protocol

Prevalence, awareness, and associated risk factors of hypertension in older adults in Africa: a systematic review and meta-analysis protocol

The occurrence and quality of care of non-communicable diseases in people living with HIV in Maseru, Lesotho: a mixed-methods study

Find and Plug the Leak: Improving Adherence to Anti-Hypertensive Medicines

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