Department of Nursing, Mbarara University of Science and Technology, Mbarara, UG.
Ron and Kathy Assaf College of Nursing, Nova Southeastern University, Colonial Court, Fort Myers, Florida, US.
Ann Glob Health. 2020 Jun 10;86(1):58. doi: 10.5334/aogh.2904.
Hypertension is a significant cardiovascular disease (CVD) and driver to CVD disorders in sub-Saharan Africa. It is a major independent risk factor for heart failure, stroke, and kidney failure. Persons living with hypertension attend to many aspects of self-care to manage their condition, including high blood pressure medication adherence to control of blood pressure. Rates of medication non-adherence, and thus uncontrolled hypertension, remain high and contribute to poor health outcomes. Understanding barriers and facilitators to adherence to hypertension therapies can help improve health outcomes.
The aim of the study was to describe the common reasons for adherence and non-adherence to antihypertensive medication from patients' perspectives.
A qualitative study engaged clients of an out-patient clinic of a regional referral hospital in southwestern Uganda who were living with hypertension as participants. One-on-one in-depth interviews provided the narrative data. The interview transcripts were analyzed using thematic analysis.
Sixteen participants provided the data for the findings. The themes identified as facilitators for adherence to antihypertensive medication were patients' understanding of prescribed medication, availability of medication for hypertension, family support for patients living with hypertension, and regular review appointments at the hypertensive clinics. Conversely, lack of supply in government dispensaries, use of self-prescribed analgesic medication, and stigma were identified as barriers and challenges of adherence to antihypertensive medication.
There is an urgent need for the health ministry to improve availability of high blood pressure medication and for health care providers to deliver individualized patient centered care, and sensitization on danger of self-prescription and measures that reduce stigma. These strategies may improve adherence to high blood pressure medication.
高血压是撒哈拉以南非洲地区的一种重大心血管疾病（CVD），也是导致 CVD 疾病的主要因素。它是心力衰竭、中风和肾衰竭的主要独立风险因素。高血压患者需要注意许多自我护理方面来控制病情，包括服用高血压药物来控制血压。药物不依从率，即高血压无法得到控制，仍然很高，导致健康状况不佳。了解高血压治疗的依从性的障碍和促进因素有助于改善健康结果。
本研究旨在从患者的角度描述对降压药物的依从和不依从的常见原因。
这项定性研究的参与者是乌干达西南部一家地区转诊医院的门诊病人，他们患有高血压。一对一的深入访谈提供了叙述性数据。使用主题分析对访谈记录进行分析。
16 名参与者提供了发现的资料。促进对降压药物依从性的因素包括患者对处方药物的理解、高血压药物的供应、对高血压患者的家庭支持以及高血压诊所的定期复诊预约。相反，政府药房供应不足、使用自我开处方的镇痛药以及污名化被确定为对降压药物依从性的障碍和挑战。
卫生部迫切需要提高高血压药物的供应，医疗保健提供者需要提供个性化的以患者为中心的护理，并对自我开处方的危险和减少污名化的措施进行宣传。这些策略可能会提高高血压药物的依从性。
