Patient-related beliefs and adherence toward their medications among the adult hypertensive outpatients in Tanzania

Abstract

This version is available at https://strathprints.strath.ac.uk/59545/ Strathprints is designed to allow users to access the research output of the University of Strathclyde. Unless otherwise explicitly stated on the manuscript, Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Please check the manuscript for details of any other licences that may have been applied. You may not engage in further distribution of the material for any profitmaking activities or any commercial gain. You may freely distribute both the url (https://strathprints.strath.ac.uk/) and the content of this paper for research or private study, educational, or not-for-profit purposes without prior permission or charge.Any correspondence concerning this service should be sent to the Strathprints administrator: strathprints@strath.ac.ukThe Strathprints institutional repository (https://strathprints.strath.ac.uk) is a digital archive of University of Strathclyde research outputs. It has been developed to disseminate open access research outputs, expose data about those outputs, and enable the management and persistent access to Strathclyde's intellectual output. AbstractIntroduction: Hypertension is a leading global health problem requiring lifelong treatment. However, adherence to antihypertensive medicines is a problem, higher among developing countries. Consequently, there is a need to determine current adherence rates and their associations among developing countries to plan future initiatives. Methods: Cross-sectional study among adult outpatients with essential hypertension in Tanzania. Pre-designed questionnaires were used to gather information on adherence rates and patient-related beliefs. The main outcome measure was adherence. Results: 180 participants were included, with females making up 65%. High adherence rates in 54% of patients. Patients' belief about their medication and its necessity were higher in the high adherent group and concerns about their medicines and their necessity higher in the low adherent group. Conclusion: Adherence rates were low compared to a suggested level ≥ 80 %.

Evaluation of antihypertensive adherence and its determinants at primary healthcare facilities in rural South Africa

“…The greatest prevalence worldwide for hypertension is in the African Region, where up to 46% of adults aged 25 or over in 2008 had hypertension [2], with up to three quarters or more of hypertensive patients currently failing to achieve target blood pressure (BP) goals [7−12]. It is perceived that a lack of adherence to medication is the major causative factor for uncontrolled hypertension [1,4,[6][7][8][11][12][13][14][15][16]. Non-adherence to medicines affects up to 30-50% of patients or more with chronic conditions including hypertension [8,17,18], with poor adherence levels seen even in the first year of treatment [12,19,20].…”

“…It is perceived that a lack of adherence to medication is the major causative factor for uncontrolled hypertension [1,4,[6][7][8][11][12][13][14][15][16]. Non-adherence to medicines affects up to 30-50% of patients or more with chronic conditions including hypertension [8,17,18], with poor adherence levels seen even in the first year of treatment [12,19,20]. The consequences of non-adherence to antihypertensive medication are not only poorer health outcomes, including higher cardiovascular mortality, but also increased health care costs and poorer economy to the country [1, 17,18, 20−22].…”

“…Factors affecting adherence are complex [1,6], and can include patients' beliefs and perceptions about the disease and treatment, medication side-effects, treatment regimens, treatment support including family members, unintentional behaviour such as patients forgetting to take their medication or intentional behaviour as in the case of certain beliefs and perceptions [1,6,11,12,14,30]. Other factors affecting adherence include unrealistic expectations of treatment such as a cure for their hypertension, depression from being newly diagnosed or knowing that hypertension is not curable, as well as the use of herbal preparations [9,10,12,31]. Unavailability of antihypertensive medicines at PHC facilities, a low level of formal education, and other factors such as the distance to treatment facilities, medication costs, and the availability of professional guidance, are also associated with nonadherence to treatment [7,9,12,16,30,32].…”

“…Other factors affecting adherence include unrealistic expectations of treatment such as a cure for their hypertension, depression from being newly diagnosed or knowing that hypertension is not curable, as well as the use of herbal preparations [9,10,12,31]. Unavailability of antihypertensive medicines at PHC facilities, a low level of formal education, and other factors such as the distance to treatment facilities, medication costs, and the availability of professional guidance, are also associated with nonadherence to treatment [7,9,12,16,30,32].…”

Knowledge regarding medicines management of type 2 diabetes amongst patients attending a Community Health Centre in South Africa

“…[50][51][52][53][54][55] Such activities though must take account of the fact that the patient population attending CHCs in South Africa (Table 1) typically have no formal education or only primary education, similar to other ambulatory care settings in South Africa and other African countries. [9,20,24,[56][57][58] Consequently, storytelling and other similar approaches may be appropriate, alongside initiatives such as diaries, pictograms and counselling involving pharmacists, to improve patient knowledge and subsequent medicine use. [59][60][61] However, we are aware that socio-demographic and cultural barriers including issues of exercise, diet and self-monitoring of blood glucose levels, have restricted self-care activities in developing countries.…”