scholarly journals Patient, clinician and logistic barriers to blood pressure control among adult hypertensives in rural district hospitals in Rwanda: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
J. P. Sibomana ◽  
R. L. McNamara ◽  
T. D. Walker
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Rural District ◽  
World Health ◽  
Medication Cost ◽  
Hypertension Management ◽  
Cross Sectional ◽  
Major Barrier ◽  
District Hospitals

Abstract Background Hypertension management in rural, resource-poor settings is difficult. Detailed understanding of patient, clinician and logistic factors which pose barriers to effective blood pressure control could enable strategies to improve control to be implemented. Methods This cross-sectional, multifactorial, observational study was conducted at four rural Rwandan district hospitals, examining patient, clinician and logistic factors. Questionnaires were administered to consenting adult outpatient hypertensive patients, obtaining information on sociodemographic factors, past management for hypertension, and adherence (by Morisky Medication Adherence 8-item Scale (MMAS-8). Treating clinicians identified local difficulties in providing hypertension management from a standard World Health Organisation list and nominated their preferred treatment regimens. Blood pressure measurements and other clinical data were collected during the study visit and used to determine blood pressure control, according to goals from JNC-8 guidelines. Medication availability and cost at each hospital’s pharmacy were reviewed as logistic barriers to treatment. Results The 112 participating patients were 80% female, with only 41% having completed primary education. Self-reported adherence by the MMAS-8 was high in 77% (86/112) and significantly associated) with literacy, lack of medication side effects and the particular hospital and pharmacy attended (all p < 0.05). However, of 89 patients with blood pressure data, only 26 (29%) had achieved goal blood pressure. No patient factor were statistically associated with poor blood pressure control. Among 30 participating clinicians, deficiencies in knowledge were evident; 43% (13/30) and 37% (11/30) chose a loop diuretic as their prescribed medication and as an ideal medication, respectively, for a newly diagnosed hypertensive patient without comorbidities, counter to JNC 8 recommendations, and 50% (15/30) identified clinician non-adherence to hypertension guidelines as a barrier. In the pharmacies, common anti-hypertensive medications were affordably available (> 6 out of 8 examined medications available in all pharmacies, cost <US$0.50 per month); however, clinicians perceived medication cost and availability to be barriers to care. Conclusions Clinician-based factors are a major barrier to blood pressure control in rural district hospitals in Rwanda, and blood pressure control overall was poor. Patient and logistic barriers to blood pressure were not evident in this study.

scholarly journals Efficacy of a Culturally and Linguistically Competent Community Health Coach Intervention for Chinese with Hypertension

2020 ◽  
Vol 5 (3) ◽  
pp. 111-119
Author(s):  
Wen-Wen Li ◽  
Donna Lew ◽  
Linda Quach
Keyword(s):  
Blood Pressure ◽  
Community Health ◽  
Blood Pressure Control ◽  
Chinese Immigrants ◽  
Pressure Control ◽  
Management Program ◽  
Hypertension Management ◽  
Health Coach ◽  
Cross Sectional ◽  
Question And Answer

Purpose: To develop and pilot test the efficacy of a culturally and linguistically sensitive, community health coach (CHC)-based intervention in Chinese immigrants in improving blood pressure control and medication adherence. Design: This study was conducted in 2017 with a cross-sectional design (n = 23). A CHC intervention was implemented using one 25-minute group educational presentation plus one 10-minute question and answer session at baseline, followed by four, 10-minute bi-weekly group question-and-answer sessions. Findings: There was a significant reduction in both systolic and diastolic blood pressure from baseline to week 8: Systolic BP −17.33 (±11.32) (p < 0.005) and diastolic BP −9.58 (±6.57) (p < 0.005). The mean score for medica- tion adherence was 10.56 (±3.24) (possible range 3–15) at baseline and there was no significant change at week 8 (mean 10.89 ± 3.95) (p = 0.86). Conclusion: The CHC-based hypertension management program showed significant reductions in both systolic and diastolic blood pressures in Chinese immigrants. Since the proposed CHC-based hypertension management program is low cost and easy to establish, further investigation is recommended to generate more results for comparison. Practice Implications: There is potential for the CHC intervention to be implemented in clinical settings to help Chinese immigrants at large achieve optimal blood pressure control.

scholarly journals Blood pressure control in chronic kidney disease: A cross-sectional analysis from the German Chronic Kidney Disease (GCKD) study

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0202604 ◽  
Author(s):  
Markus P. Schneider ◽  
Karl F. Hilgers ◽  
Matthias Schmid ◽  
Silvia Hübner ◽  
Jennifer Nadal ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

Effects of Confounding Factors on Blood Pressure in Hypertensive Patients: A Cross Sectional Study

2021 ◽  
Author(s):  
Emrah Ersoy ◽  
Cuneyt Ardic
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Control Group ◽  
Poor Sleep ◽  
Study Group ◽  
Confounding Factors ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Significant Difference

Abstract Background Blood pressure is influenced by biopsychosocial factors such as physical, environmental, emotional, cognitive and behavioral in hypertensive patients. ObjectiveThe aim of this study is to investigate confounding factors in hypertensive patients who have poor blood pressure control.DesignThis study was designed as a cross-sectional study.ParticipantsOur sample was 407 patients with hypertension in Rize, a Northern city in the Black Sea Region of Turkey. In study group, there were 207 hypertensive patients who had admission to emergency department due to high blood pressure. In control group, there were 200 hypertensive patients visiting family physician,who defined themselves as having regulated blood pressure over the past six months.Main MeasuresPatients completed the questionnaire including sociodemographic data, lifestyle behaviors, health risks and confounding factors via the face-to-face interview method. Key ResultsOf the hypertensive patients, 81.2% (n=168) of the study group and 34.0% (n=68) of the control group had confounding factors. There was a significant difference between the hypertensive patients of study and control group in terms of their confounding factors (p<0.001). When we asked the patients of study group questions to reveal their confounding factors, 21.3% (n=44) stated ‘anger’, 12.6% (n=26) ‘sadness’, 11.1% (n=23) ‘anxiety’, 10.6% (n=22) ‘depressed’, 9.2% (n=19) ‘unhealthy diet’, 7.2% (n=15) ‘fatigue and poor sleep quality’, and 3.9% (n=8) ‘irregular medication’. Mean systolic and diastolic blood pressure were significantly higher in hypertensive patients having confounding factors than those without confounding factors (p=0.001, p=0.001, respectively). Mean systolic blood pressure of hypertensives who stated their confounding factor as ‘anger’ was significantly higher than those the remaining groups (p<0.001).ConclusionsThis study has shown that confounding factors impair blood pressure control in patients with hypertension. Confounding factors should be kept in mind and revealed in case of poor blood pressure control in hypertensive patients.

scholarly journals Socio-demographic, Clinical Characteristics and Status of Hypertension Control among Rural Hypertensive Patients

1970 ◽  
Vol 6 (1) ◽  
pp. 5-9
Author(s):  
NU Ahmed ◽  
M Rahman ◽  
MDU Islam ◽  
SY Ali ◽  
AM Hossain ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Clinical Characteristics ◽  
Pressure Control ◽  
Cross Sectional Study ◽  
Hypertension Control ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Education And Awareness ◽  
Males And Females

Hypertension is an important independent predictor of cardiovascular disease, cerebrovascular accidents and death. The prevalence of cardiovascular diseases and hypertension is rapidly increasing in developing countries. A cross sectional study was conducted among 103 hypertensive patients during December 2009 to June 2010 in Goshair Hat Upazilla of Shariatpur District to determine the socio-demographic, clinical characteristics and status of control of hypertension in rural population. Respondents were distributed more or less equally among males and females. The mean ± SD and median age of the respondents were calculated as 59.97 ± 11.12 years, with 64% of them were included in the age group of 51 to 70 years. More than half of the respondents were housewives (51.5%), which were followed by businessmen (21.4%). Every three of five patients were over weight, while 22.3% respondents were obese. One third of the respondents were also diabetic (33%). None of the 103 patients had achieved the target for SBP (Systolic blood pressure) control (<140mm of Hg) and only 21.4% of the patients had achieved the target for DBP (Diastolic blood pressure) control (<90 mm of Hg). Again none of the diabetic hypertensive patients had achieved the target for SBP control (<130mm of Hg) and only one patient had achieved the target for DBP control (<80 mm of Hg). Overall five patients were found to have uncontrolled and severe hypertension (BP >180/110 mm of Hg), all of whom were female. From this study control of hypertension was found poor among rural hypertensive population. For effectively combating the burden of hypertension in this population, education and awareness about hypertension needs to be given priority. Key words: Hypertension; socio-demographic characteristics; rural area; control of blood pressure DOI: 10.3329/fmcj.v6i1.7402 Faridpur Med. Coll. J. 2011;6(1): 05-09

Correlates of Blood Pressure Control Behaviors among Korean Americans in the Greater Philadelphia Area

2013 ◽  
Vol 113 (3) ◽  
pp. 908-920 ◽  
Author(s):  
Jay Lewis ◽  
Grace Ma ◽  
Freda Patterson ◽  
Min Qi Wang
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Cross Sectional Study ◽  
Healthy Diet ◽  
Medication Regimen ◽  
Cross Sectional ◽  
Regular Doctor ◽  
Intention To Exercise

This cross-sectional study was designed to identify correlates of blood pressure control behaviors, including participation in physical activity, maintaining a healthy diet, limiting alcohol and tobacco use, discussing blood pressure with a doctor, and getting screened for blood pressure. The study sample included 116 Korean American men and women aged 42 to 77 years ( M = 58.7) who resided in the greater Philadelphia area. Intention to exercise, comfort exercising in the neighborhood, and confidence in the ability to find time to exercise were positively correlated with participating in physical activity. Knowledge about the benefits of a healthy diet and confidence in the ability to maintain a healthy diet were positively correlated with maintaining a healthy diet. Intention to visit a doctor, having a regular doctor, satisfaction with the doctor, having confidence in the doctor, and confidence in the ability to ask doctors about health issues were positively correlated with medical adherence (including adhering to medication regimen and seeing a doctor regularly).

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