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Hasan MJ, Hossain MZ, Hossain MA, Dalal K, Baset MA, Sutradhar P, Alam M, Tabassum T, Fardous J, Zaman P, Rafi MA, Khan MAS, Hawlader MDH. Health-care-seeking behaviour in patients with hypertension: experience from a dedicated hypertension centre in Bangladesh. Blood Press 2024; 33:2339434. [PMID: 38696746 DOI: 10.1080/08037051.2024.2339434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 03/22/2024] [Indexed: 05/04/2024]
Abstract
Objective: The study aimed to assess health-seeking behaviour (HSB) and associated factors among hypertensive patients in Bangladesh.Methods: This cross-sectional study was conducted in the Hypertension & Research Centre, Rangpur, Bangladesh, between January 2022 and June 2022. A total of 497 hypertensive adults were recruited consecutively. A pre-tested structured questionnaire was deployed by the research team for data collection. Multivariable logistic regression analysis was used to explore the predictors of HSB.Results: The mean age of the hypertensive patients was 52 ± 11 (SD) years. Most of them were aged between 51 and 60 years (33%), female (55%), came from rural areas (57%), and belonged to middle socioeconomic class (68%). One-fourth of the patients (27%) had chosen informal healthcare providers for their first consultation. Fear of stroke (244, 45%), headache (170, 36%), and neck pain (81, 17%) were the three most common compelling causes of their visit to the hypertension centre. Age (aOR 0.78, 95% CI 0.68 - 0.89), male sex (aOR: 1.79, 95% CI 1.05 - 3.10), living in semi-urban (aOR 4.68, 95% CI 1.45 - 15.10) and rural area (aOR 1.68, 95% CI 1.01 - 2.80), farmers as occupation (aOR: 3.24, 95%CI: 1.31 - 8.06) and belonging to lower social economic class (aOR 4.24, 95% CI 1.68 - 10.69) were predictors of visiting informal providers of hypertensive patient. One-fourth of the hypertensive patients received consultation from informal healthcare providers.Conclusions: Raising awareness among patients and proper referral to specialised hypertension centres could promulgate the patients towards appropriate behaviour.
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Affiliation(s)
| | | | | | - Koustuv Dalal
- Division of Public Health Science, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | | | | | - Mahabubul Alam
- Tropical Disease and Health Research Center, Dhaka, Bangladesh
| | | | | | - Paramita Zaman
- Tropical Disease and Health Research Center, Dhaka, Bangladesh
| | - Md Abdur Rafi
- Tropical Disease and Health Research Center, Dhaka, Bangladesh
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Bamgboye E, Ayoyemi A, Salawu MM, Akinyemi JO, Ogah OS, Uja UA, Jalo RI, Oyewole O, Sani M, Ajayi IO. Treatment seeking behaviour and associated factors among adults with high blood pressure from three selected states in Nigeria. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002949. [PMID: 38630739 PMCID: PMC11023577 DOI: 10.1371/journal.pgph.0002949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 01/29/2024] [Indexed: 04/19/2024]
Abstract
Management of hypertension is challenging in multi-cultural and multi-ethnic sub-Saharan African countries like Nigeria. This diversity calls for multi-dimensional interventional approaches for hypertension control. This study assessed the treatment seeking behaviour and associated factors among adults with high blood pressure from three ethnic groups in Nigeria. A cross-sectional study was conducted among 762 adults with high blood pressure from three purposively selected States representing the three main tribes in Nigeria. Using a multistage stratified sampling technique, five communities were selected from two Local Government Areas (LGAs) stratified into urban and rural LGAs in each State. All consenting respondents in each community were consecutively screened for hypertension and recruited. A pretested interviewer-administered questionnaire was used to obtain information on socio-demographic characteristics, treatment seeking behaviour and factors affecting their choice. Data were summarized using descriptive statistics. Relationship between individual, health-related factors and treatment seeking behaviour, as well as the predictors were assessed using a binary logistic regression. at p<0.05 Participants' mean age was 55.4 ± 16.6 years, 63.0% were females and most were Igbo speaking (39.9%). About half (368, 48.3%) were unaware of their status. Of those aware, most (58.9%) went to hospital upon diagnosis of hypertension while some sought advice from health care professionals (28.5%) mostly Hausas, others either went to chemists (6.2%) or did nothing (5.1%), predominantly Yorubas. Significant predictors of orthodox treatment seeking practices for hypertension were female gender [(AOR = 2.60; 95%CI (1.18-5.71)], availability of medicine and personnel [(AOR = 8.7; 95%CI (4.15-18.3)] and perceived good quality of care [(AOR = 4.88; 95%CI (1.81-13.1)]. Orthodox treatment was the common choice among adults with high blood pressure. To further encourage patronage of orthodox treatment, the health facilities should be adequately equipped with medications and trained personnel to improve the quality of care. Targeted education on continuous practice of orthodox treatment is recommended.
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Affiliation(s)
- Eniola Bamgboye
- Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Abiola Ayoyemi
- Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mobolaji Modinat Salawu
- Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Joshua Odunayo Akinyemi
- Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Okechukwu Samuel Ogah
- Faculty of Clinical Sciences, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Uzoamaka Alice Uja
- Department of Public Health, Ministry of Health, Abia State, Umuahia, Nigeria
| | | | - Oyediran Oyewole
- Faculty of Public Health, Department of Health Promotion and Education, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mahmoud Sani
- Department of Community Medicine, Bayero University Kano, Kano, Nigeria
| | - IkeOluwapo Oyeneye Ajayi
- Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Pardoel ZE, Lensink R, Postma M, Win HH, Swe KH, Stein C, Febrinasari R, My Hanh H, Koot JA, Landsman JA, Reijneveld SA. Knowledge on hypertension in Myanmar: levels and groups at risk. OPEN RESEARCH EUROPE 2023; 2:13. [PMID: 37645316 PMCID: PMC10445853 DOI: 10.12688/openreseurope.14415.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 08/31/2023]
Abstract
Background: Non-communicable diseases, specifically the burden of hypertension, have become a major public health threat to low- and middle-income countries, such as Myanmar. Inadequate knowledge of hypertension and its management among people may hinder its effective prevention and treatment with some groups at particular increased risks, but evidence on this is lacking for Myanmar. The aims of this study were therefore to assess the level of knowledge of risk factors, symptoms and complications of hypertension, by hypertension treatment status, community group-membership, and sociodemographic and socioeconomic factors in Myanmar. Methods: Data was collected through structured questionnaires in 2020 on a random sample of 660 participants, stratified by region and existence of community groups. Knowledge of hypertension was measured with the 'Knowledge' part of a validated 'Knowledge, Attitude and Practice' survey questionnaire and categorised into ill-informed and reasonably to well-informed about hypertension. Results: The majority of respondents seem reasonably to well-informed about risk factors, symptoms and complications of hypertension. This did not vary by hypertension treatment status and community group membership. People with jobs (B=0.96; 95%-confidence interval 0.343 to 1.572) and higher education (B=1.96; 0.060 to 3.868) had more hypertension knowledge than people without jobs or low education. Adherence to treatment among hypertensive people was low. Conclusion: This study shows a majority of participants in this study in Myanmar seem reasonably to well-informed, with no differences by hypertension status, treatment status, and community group-membership. People without jobs and low education have less hypertension knowledge, making them priority groups for tailored education on health care level as well as community level, lowering the burden of hypertension. Almost half of the hypertensive patients did not take their medicines and therefore, adherence to treatment of hypertension should be an important element for future health education.
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Affiliation(s)
- Zinzi E. Pardoel
- Health Sciences, University Medical Center Groningen, Groningen, Groningen, 9700 RB, The Netherlands
| | - Robert Lensink
- Faculty of Economics and Business, University of Groningen, Groningen, Groningen, The Netherlands
| | - Maarten Postma
- Health Sciences, University Medical Center Groningen, Groningen, Groningen, 9700 RB, The Netherlands
- Faculty of Economics and Business, University of Groningen, Groningen, Groningen, The Netherlands
| | - Hla Hla Win
- University of Public Health, Yangon, Myanmar
| | | | | | - Ratih Febrinasari
- Department of Pharmacology, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Hoang My Hanh
- Health Strategy and Policy Institute, Hanoi, Vietnam
| | - Jaap A.R. Koot
- Health Sciences, University Medical Center Groningen, Groningen, Groningen, 9700 RB, The Netherlands
| | - Johanna A. Landsman
- Health Sciences, University Medical Center Groningen, Groningen, Groningen, 9700 RB, The Netherlands
| | - Sijmen A. Reijneveld
- Health Sciences, University Medical Center Groningen, Groningen, Groningen, 9700 RB, The Netherlands
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Mekie M, Bezie M, Melkie A, Addisu D, Chanie ES, Bayih WA, Biru S, Hailie M, Seid T, Dagnew E, Muche T, Alemu EM. Perception towards preeclampsia and perceived barriers to early health-seeking among pregnant women in selected Hospitals of South Gondar Zone, Northwest Ethiopia: A qualitative study. PLoS One 2022; 17:e0271502. [PMID: 35926064 PMCID: PMC9352094 DOI: 10.1371/journal.pone.0271502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/02/2022] [Indexed: 11/24/2022] Open
Abstract
Background Preeclampsia is one of the top maternal morbidity and mortality that disproportionately affects pregnant women in low and middle-income countries where access and quality of health services are limited. People in different areas perceive preeclampsia differently which directly or indirectly affects the timing and place of heath seeking. Positive perception about perceived causes, perceived complications, and prevention of preeclampsia is central for the prediction and early diagnosis of the disease. However, little is known about the perception of pregnant women towards preeclampsia in Ethiopia. This study aimed to assess the perception towards preeclampsia and perceived barriers to early health-seeking among pregnant women in selected Hospitals of South Gondar Zone, Northwest Ethiopia. Methods A qualitative study using phenomenological approach was implemented among 20 purposively selected pregnant women who visited health facilities for antenatal care service in four selected Hospitals of the South Gondar Zone of the Amhara Region. Data were collected through an in-depth interview (IDI) using a semi-structured interview guide from January to February 2020. Thematic analysis was executed using Open Code Software version 4.03. Results The majority of the participants believed preeclampsia as a pregnancy-specific hypertensive disease and mainly associated it with overweight and nutritional problems. With regards to the perceived severity, the study participants agreed that preeclampsia can lead women to death. Personal delay, lack of awareness about the disease, transport problem, and low socioeconomic condition were perceived as the major reasons for the delay to early health-seeking (the 1st and the 2nd delay). While poor service provision and long waiting times were the barriers to receive services at the health facility level (the 3rd delay). Conclusion The majority of the participants believed preeclampsia as a pregnancy-specific hypertensive disease and mainly associated it with overweight and nutritional problems. The finding of this study implied that awareness creation about the danger of hypertension during pregnancy and its risk reduction mechanisms shall be emphasized. The care provision at health facilities shall be improved by decreasing long waiting time which discourages service utilizations aside from improving early seeking behavior of pregnant women through different interventions.
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Affiliation(s)
- Maru Mekie
- Department of Midwifery, Debre Tabor University, College of Health Sciences, Debre Tabor, Ethiopia
- * E-mail:
| | - Minale Bezie
- Department of Midwifery, Debre Tabor University, College of Health Sciences, Debre Tabor, Ethiopia
| | - Abenezer Melkie
- Department of Midwifery, Debre Tabor University, College of Health Sciences, Debre Tabor, Ethiopia
| | - Dagne Addisu
- Department of Midwifery, Debre Tabor University, College of Health Sciences, Debre Tabor, Ethiopia
| | - Ermias Sisay Chanie
- Department of Pediatrics and Child Health Nursing, Debre Tabor University, College of Health Sciences, Debre Tabor, Ethiopia
| | - Wubet Alebachew Bayih
- Department of Pediatrics and Child Health Nursing, Debre Tabor University, College of Health Sciences, Debre Tabor, Ethiopia
| | - Shimeles Biru
- Department of Midwifery, Debre Tabor University, College of Health Sciences, Debre Tabor, Ethiopia
| | - Mekonnen Hailie
- Department of Midwifery, Debre Tabor University, College of Health Sciences, Debre Tabor, Ethiopia
| | - Tigist Seid
- Department of Midwifery, Debre Tabor University, College of Health Sciences, Debre Tabor, Ethiopia
| | - Enyew Dagnew
- Department of Midwifery, Debre Tabor University, College of Health Sciences, Debre Tabor, Ethiopia
| | - Tewachew Muche
- Department of Midwifery, Debre Tabor University, College of Health Sciences, Debre Tabor, Ethiopia
| | - Eshetie Molla Alemu
- Department of Public Health, Debre Tabor University, College of Health Sciences, Debre Tabor, Ethiopia
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Krishnamoorthy Y, Rajaa S, Rehman T, Thulasingam M. Patient and provider's perspective on barriers and facilitators for medication adherence among adult patients with cardiovascular diseases and diabetes mellitus in India: a qualitative evidence synthesis. BMJ Open 2022; 12:e055226. [PMID: 35332041 PMCID: PMC8948385 DOI: 10.1136/bmjopen-2021-055226] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To explore the various stakeholders' perspectives on barriers and facilitators for medication adherence among patients with cardiovascular diseases (CVDs) and diabetes mellitus (DM)in India. DESIGN Systematic review of qualitative studies. DATA SOURCES A comprehensive systematic search was conducted in Medline, Cochrane Library, Science Direct and Google Scholar from January 2010 to July 2020. We included all qualitative peer-reviewed studies, reporting barriers and facilitators of medication adherence, from India, for our current review. DATA EXTRACTION AND SYNTHESIS Data extraction was performed by two independent authors who also assessed the quality of included studies using the Critical Appraisal Skills Programme criteria. This qualitative evidence synthesis adhered to the enhancing transparency in reporting the synthesis of qualitative research checklist RESULTS: In total, 18 studies were included. Major barriers reported were lack of understanding about the disease, complications related to non-adherence, followed by forgetfulness, lack of family support and risk communication. Health system-related barriers such as accessibility, affordability and acceptability were also reported by majority of the studies. Creation of peer support groups, digital reminder systems, integration of native Indian systems of India, physiotherapy and geriatric clinics at the primary healthcare level and innovations in patient care were suggested to counter these barriers in medication adherence. CONCLUSION Such patient-specific targeted interventions need to be developed to achieve better control among patients with CVD and DM.PROSPERO registration numberCRD42020199529.
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Affiliation(s)
| | - Sathish Rajaa
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
| | - Tanveer Rehman
- Department of Preventive and Social Medicine, PGIMER, Chandigarh, Chandigarh, India
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