Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.
Afr J Prim Health Care Fam Med. 2020 Jun 17;12(1):e1-e7. doi: 10.4102/phcfm.v12i1.2222.
Sub-Saharan Africa faces an increasing burden of non-communicable diseases. In particular, hypertension and its therapeutic control present a challenge and opportunity for health practitioners and health systems within the region.
This study sought to assess an initiative conducted by two health clinics to begin treatment of hypertension amongst their patient populations by reviewing medication possession rates and documenting patient-reported barriers to care in the provision of chronic hypertension management.
Two private, outpatient health clinics in Sierra Leone recently beginning hypertension management initiatives.
A retrospective chart review identified 487 records of patients with diagnosed hypertension and assessed for medication adherence through calculation of medication possession ratios from pharmacy refill data. Surveys were conducted on a convenience sample of 68 patients of the hypertension treatment programme to discern patient-reported barriers of care.
Medication possession rates were found to be less than 40% in 82% (399/487) of patients, between 40% and 79% in 12% (60/487) of patients and 80% or greater in 6% (28/487) of patients. In surveys of individuals being treated by the programme, patients were most likely to cite transportation (81%, 55/68), financial burden (69%, 47/68) and schedule conflicts with work or other prior commitments (25%, 17/68) as barriers to care.
In this newly instituted outpatient hypertensive management initiative, 82% of patients had medication possession ratios under 40%, which is likely to impact the clinical effectiveness of the initiative. The most frequent patient-reported barriers to care in surveys included transportation, financial burden and schedule conflicts.
撒哈拉以南非洲地区面临着非传染性疾病负担日益加重的问题。特别是，高血压及其治疗控制对该地区的医疗保健从业者和卫生系统构成了挑战和机遇。
本研究旨在评估两个诊所开展的一项倡议，该倡议通过审查药物持有率并记录患者报告的在提供慢性高血压管理方面的护理障碍，开始为其患者人群治疗高血压。
塞拉利昂的两家私人门诊诊所最近开始开展高血压管理计划。
回顾性病历审查确定了 487 例确诊为高血压的患者记录，并通过从药房补充数据计算药物持有率来评估药物依从性。对高血压治疗计划的 68 名患者进行了一项便利抽样调查，以了解患者报告的护理障碍。
发现 82%（399/487）的患者药物持有率低于 40%，12%（60/487）的患者药物持有率在 40%至 79%之间，6%（28/487）的患者药物持有率在 80%或更高。在对参与该计划治疗的个体进行的调查中，患者最有可能将交通（81%，55/68）、经济负担（69%，47/68）和与工作或其他先前承诺的日程冲突（25%，17/68）列为护理障碍。
在这项新开展的门诊高血压管理计划中，82%的患者药物持有率低于 40%，这可能会影响该计划的临床效果。调查中患者报告的最常见护理障碍包括交通、经济负担和日程冲突。
