Treating patients with hypertension in Indonesia’s primary health care centre: A challenging condition

Abstract

Background. In Indonesia, hypertension treatment relies on primary health care services, and there are no current data on blood pressure control and hypertension treatment in Indonesia’s primary health care system.Methods. We conducted a cross-sectional study including all patients with hypertension (n = 273) who visited the Tegal Alur II Community Health Center in 2017. For all patients with hypertension, medical records containing the most recent blood pressure results and antihypertensive treatments were examined by the authors. The primary outcome in this study was optimal blood pressure control according to the Joint National Committee (JNC) VII guidelines.Results. The mean systolic and diastolic blood pressures were 143.7 mmHg (SD 18.5) and 87 mmHg (SD 11.4), respectively. Calcium channel blockers were the most frequently used antihypertensive agents (58.6%). Of all patients with hypertension, 27.1% achieved controlled blood pressure. Bivariate analysis revealed a significant association between antihypertensive agents and blood pressure control (p = 0.009). Multivariate analysis showed that calcium channel blockers were the strongest predictor of blood pressure control, with an adjusted odds ratio of 1.9 (95% confidence interval CI [1.1–3.5], p = 0.022).Conclusion. Controlled blood pressure was achieved by less than half of all patients with hypertension visiting the Tegal Alur II Community Health Center in 2017. The majority of patients with hypertension received single-drug therapy with calcium channel blockers, the most frequently used antihypertensive agents. There was a significant association between antihypertensive agents and blood pressure control.Funding. This study received no financial support from any specific funding agencies.

Community diagnosis in Sei Selayur urban village, Palembang, Indonesia: Actual approach for the assessment of health and social factors

“…Difficulty in maintaining adherence is based on various factors such as difficulty in remembering daily medication consumption, the misconception of drug side effects, the complexity of the therapeutic regimen, high treatment costs, difficult access to treatment, and long treatment period (Daniel and Veiga 2013). This is a contributing factor to the poor control of hypertension status in patients, especially in middle to lower-income countries, including Indonesia, which only has 27.1% of patients with controlled hypertension (Bawazir and Sianipar 2019). In addition, bad lipid control in the observed patients was significantly related to our findings (all patients with hypertension have uncontrolled blood pressure) (Umar and Mariana 2021).…”

Longitudinal evidence on treatment discontinuation, adherence, and loss of hypertension control in four middle-income countries

“…Indonesia also displayed the highest treatment discontinuation and lowest treatment initiation rates, suggesting the presence of substantial barriers in both access to and follow-up of hypertension care. Hypertension treatment relies primarily on primary health care services, which are affected by a shortage of health professionals, the geographically unequal distribution of facilities, and a low population health insurance coverage (40)(41)(42). In recent years, health insurance coverage has increased substantially with the introduction of the Indonesian National Health Insurance (Indonesian: Jaminan Kesehatan Nasional) program in 2014 (43).…”