Poor drug adherence and lack of awareness of hypertension among hypertensive stroke patients in Kampala, Uganda: a cross sectional study

Abstract

BackgroundRaised blood pressure (BP) remains an important risk factor for cardiovascular diseases such as stroke. Adherence to therapeutic recommendations especially antihypertensive drugs is important in BP control. The aim of the study was to assess the stroke risk factors and levels of adherence among hypertensive patients with stroke in Kampala Uganda.MethodsIn a cross-sectional study we describe 112 hypertensive subjects with stroke from two Kampala city hospitals. A standardized pre-tested questionnaire was used to collect medical history, clinical details, radiological findings and laboratory data.ResultsA total of 112 hypertensive subjects with stroke were enrolled between May 2013 and April 2014. The median ages were 63.5 years (52.5–75.0) for the cases. Seventy percent (78/112) of the study participants had ischemic strokes. Only 17 % were adherent to anti-hypertensive medications. The main cause of non-adherence appears to be lack of knowledge.ConclusionsPoor adherence of anti-hypertensive medications among hypertensive patients remains a big challenge in our setting. This has been attributed to lack of adequate knowledge and cost of the prescribed drugs. There is therefore an urgent need to promptly diagnose and educate hypertensive patients with emphasis on adherence to anti hypertensive drugs.

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

“…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 ].…”

Non-Adherence to Antihypertensive Drugs: A Systematic Review and Meta-Analysis

“…Finally, 28 articles were included in the systematic review and 25 of these were included in the meta-analysis. [9,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][27][28][29][30][31][33][34][35][36] …”

“…[10,18] Countries such as Uganda, Lebanon, Kenya, Republic of Korea, Peru, Ethiopia, Ghana, Malaysia, Palestine, Brazil, and Italy were represented with a single study. [9,13,19,20,23,24,27,28,31,34,36] These studies were conducted on hypertensive patients to assess medication adherence using MMAS-8 between January 2009 and March 2016. Twenty-four studies were cross-sectional [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] and others were cohort, [35] observational, [36] and interventional studies.…”

“…[35] However, 8 studies did not specify the type of MMAS-8 questionnaire administered. [9,11,12,15,16,19,27,28] Except 1 study, [22] all the included studies met the quality criteria and showed high quality (>75%). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][29][30][31][32][33][34][35][36] …”

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

“…High cost of anti-hypertensive medicines was associated with poor adherence in studies from Tanzania and Uganda [18,19].…”