Osamor Pauline E, Owumi Bernard E
Department of Sociology, Bowen University, Iwo, Osun State, Nigeria.
J Health Popul Nutr. 2011 Dec;29(6):619-28. doi: 10.3329/jhpn.v29i6.9899.
Hypertension is an important condition among adults, affecting nearly one billion people worldwide. Treatment with appropriate medication is a key factor in the control of hypertension and reduction in associated risk of complications. However, compliance with treatment is often sub-optimal, especially in developing countries. The present study investigated the factors associated with self-reported compliance among hypertensive subjects in a poor urban community in southwest Nigeria. This community-based cross-sectional study employed a survey of a convenience sample of 440 community residents with hypertension and eight focus-group discussions (FGDs) with a subset of the participants. Of the 440 hypertensive respondents, 65.2% were women, about half had no formal education, and half were traders. Over 60% of the respondents sought care for their condition from the hospital while only 5% visited a chemist or a patent medicine vendor (PMV). Only 51% of the subjects reported high compliance. Factors associated with high self-reported compliance included: regular clinic attendance, not using non-Western prescription medication, and having social support from family members or friends who were concerned about the respondent's hypertension or who were helpful in reminding the respondent about taking medication. Beliefs about cause of hypertension were not associated with compliance. The findings of the FGDs showed that the respondents believed hypertension is curable with the use of both orthodox and traditional medicines and that a patient who 'feels well' could stop using antihypertensive medication. It is concluded that treatment compliance with antihypertensive medication remains sub-optimal in this Nigerian community. The factors associated with high self-reported compliance were identified. More research is needed to evaluate how such findings can be used for the control of hypertension at the community level.
高血压是成年人中的一种重要疾病，全球近10亿人受其影响。使用适当药物进行治疗是控制高血压及降低相关并发症风险的关键因素。然而，治疗依从性往往不理想，尤其是在发展中国家。本研究调查了尼日利亚西南部一个贫困城市社区中高血压患者自我报告的依从性相关因素。这项基于社区的横断面研究对440名社区高血压居民进行了便利抽样调查，并与部分参与者进行了八次焦点小组讨论（FGD）。在440名高血压受访者中，65.2%为女性，约一半没有接受过正规教育，一半是商人。超过60%的受访者因病情前往医院就医，而只有5%的人去看药剂师或成药小贩。只有51%的受试者报告依从性高。自我报告依从性高的相关因素包括：定期就诊、不使用非西方处方药，以及得到关心受访者高血压或有助于提醒受访者服药的家人或朋友的社会支持。对高血压病因的看法与依从性无关。焦点小组讨论的结果表明，受访者认为高血压可通过使用正统药物和传统药物治愈，并且“感觉良好”的患者可以停止使用抗高血压药物。研究得出结论：在这个尼日利亚社区，抗高血压药物的治疗依从性仍然不理想。确定了自我报告依从性高的相关因素。需要更多研究来评估如何将这些发现用于社区层面的高血压控制。
