Sudharsanan Nikkil, Ali Mohammed K, McConnell Margaret
Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
LEAD at Krea University, Chennai, India.
BMJ Open. 2021 Jan 20;11(1):e040252. doi: 10.1136/bmjopen-2020-040252.
A substantial share of urban Indians with diagnosed hypertension do not take regular treatment, potentially due to poor knowledge of hypertension consequences and treatment options. We describe hypertension knowledge and beliefs, treatment patterns, and reported reasons for treatment non-use among adults with diagnosed hypertension in Chennai, India.
We collected data on 833 adults ages 30+ with physician diagnosed hypertension using a door-to-door household survey within randomly selected wards of Chennai. We described the proportion of individuals who were not taking daily medications and their reported reasons for not doing so. Next, we described individuals' knowledge of hypertension consequences and how to control blood pressure (BP) and assessed the association between knowledge and daily treatment use.
Over one quarter (28% (95% CI 25% to 31%)) of diagnosed individuals reported not taking daily treatment. The largest proportion (18% (95% CI 16% to 21%)) were individuals who had discontinued prior treatment use. The primary reason individuals reported for non-daily use was that their BP had returned to normal. Just 23% (95% CI 20% to 26%) of individuals listed BP medications as the most effective way to reduce BP; however, these individuals were 11% points (95% CI 4% to 19%) more likely to take daily medications. Conversely, 43% (95% CI 40% to 47%) of individuals believed that BP medications should be stopped from time to time and these individuals were 15% points (95% CI -0.21 to -0.09) less likely to take daily treatment. While awareness of the consequences of hypertension was poor, we found no evidence that it was associated with taking daily medications.
There were large gaps in consistency of BP medication use which were strongly associated with knowledge about BP medications. Further research is needed to identify whether addressing beliefs can improve daily treatment use among individuals with diagnosed hypertension.
很大一部分被诊断患有高血压的印度城市居民没有接受正规治疗，这可能是由于对高血压后果和治疗方案了解不足。我们描述了印度钦奈被诊断患有高血压的成年人的高血压知识和信念、治疗模式以及报告的不接受治疗的原因。
我们在钦奈随机选择的病房内进行挨家挨户的家庭调查，收集了833名30岁及以上被医生诊断患有高血压的成年人的数据。我们描述了未每日服药的个体比例及其报告的未服药原因。接下来，我们描述了个体对高血压后果以及如何控制血压（BP）的了解，并评估了知识与每日治疗使用之间的关联。
超过四分之一（28%（95%置信区间25%至31%））的被诊断个体报告未每日接受治疗。最大比例（18%（95%置信区间16%至21%））是那些停止了先前治疗使用的个体。个体报告的非每日使用的主要原因是他们的血压已恢复正常。只有23%（95%置信区间20%至26%）的个体将降压药列为降低血压的最有效方法；然而，这些个体每日服药的可能性高11个百分点（95%置信区间4%至19%）。相反，43%（95%置信区间40%至47%）的个体认为降压药应不时停用，这些个体每日接受治疗的可能性低15个百分点（95%置信区间-0.21至-0.09）。虽然对高血压后果的认识较差，但我们没有发现它与每日服药有关的证据。
血压药物使用的一致性存在很大差距，这与对降压药的了解密切相关。需要进一步研究以确定解决信念问题是否可以改善被诊断患有高血压的个体的每日治疗使用情况。
