Regularity of clinical visits and medication adherence of patients with hypertension or diabetes in rural Yunnan province of China

Abstract

Objective Chronic diseases can be controlled through effective self-management. The purpose of this study is to explore the regularity of clinical visits and medication adherence of patients with hypertension or diabetes (PDH), and its association with the first experience with care and individual factors in rural Southwestern China.Methods The authors draw on a dataset which comprised of 292 PDH and 122 village clinics selected from 122 villages in 10 counties in the rural areas of Yunnan province. Data was gathered through interviews with these patients and the directors of the village clinics in January 2018. Logistic regression models were performed using STATA 15.0.Results The data shows around 31% of hypertensive and 25% of diabetic patients neither visited physicians nor took medicine regularly during the preceding three months of the interview date. We also documented PDH first experience with care and found that a proportion of them did not initially choose to seek care from health facilities. The logistic regression results indicated that individual characteristics of the PDH, including patient age, health status, and economic level, as well as their first experience with care were significantly associated with their regular healthcare behavior. Moreover, in addition to providing medical services, on average each sample village clinic with around two physicians simultaneously managed 180 hypertensive and 45 diabetic patients.Conclusions Our paper shows how current self-management trends among PDH in the sample area was unsatisfactory, threatening the effective control of hypertension and diabetes in China. Even though healthcare reforms in China have been launched since 2009, this study revealed the need for further reforms in terms of improving self-management. The authors recommend an increase in the quantity and the quality of human resources in the primary healthcare realm in rural China, which should help provide better education and supervision services for self-management.