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Perceptions of inhibitors and facilitators for adhering to hypertension treatment among insured patients in rural Nigeria: a qualitative study

Overview of attention for article published in BMC Health Services Research, December 2014
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Title
Perceptions of inhibitors and facilitators for adhering to hypertension treatment among insured patients in rural Nigeria: a qualitative study
Published in
BMC Health Services Research, December 2014
DOI 10.1186/s12913-014-0624-z
Pubmed ID
Authors

Aina O Odusola, Marleen Hendriks, Constance Schultsz, Oladimeji A Bolarinwa, Tanimola Akande, Akin Osibogun, Charles Agyemang, Gbenga Ogedegbe, Kayode Agbede, Peju Adenusi, Joep Lange, Henk van Weert, Karien Stronks, Joke A Haafkens

Abstract

BackgroundUniversal health care coverage has been identified as a promising strategy for improving hypertension treatment and control rates in sub Saharan Africa (SSA). Yet, even when quality care is accessible, poor adherence can compromise treatment outcomes. To provide information for adherence support interventions, this study explored what low income patients who received hypertension care in the context of a community based health insurance program in Nigeria perceive as inhibitors and facilitators for adhering to pharmacotherapy and healthy behaviors.MethodsWe conducted a qualitative interview study with 40 insured hypertensive patients who had received hypertension care for¿>¿1 year in a rural primary care hospital in Kwara state, Nigeria. Supported by MAXQDA software, interview transcripts were inductively coded. Codes were then grouped into concepts and thematic categories, leading to matrices for inhibitors and facilitators of treatment adherence.ResultsImportant patient-identified facilitators of medication adherence included: affordability of care (through health insurance); trust in orthodox ¿western¿ medicines; trust in Doctor; dreaded dangers of hypertension; and use of prayer to support efficacy of pills. Inhibitors of medication adherence included: inconvenient clinic operating hours; long waiting times; under-dispensing of prescriptions; side-effects of pills; faith motivated changes of medication regimen; herbal supplementation/substitution of pills; and ignorance that regular use is needed. Local practices and norms were identified as important inhibitors to the uptake of healthier behaviors (e.g. use of salt for food preservation; negative cultural images associated with decreased body size and physical activity) Important factors facilitating such behaviors were the awareness that salt substitutes and products for composing healthier meals were cheaply available at local markets and that exercise could be integrated in people¿s daily activities (e.g. farming, yam pounding, and household chores).ConclusionsWith a better understanding of patient perceived inhibitors and facilitators of adherence to hypertension treatment, this study provides information for patient education and health system level interventions that can be designed to improve compliance.Trial registration ISRCTN47894401.

Mendeley readers

The data shown below were compiled from readership statistics for 152 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 2 1%
Unknown 150 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 26 17%
Researcher 22 14%
Unspecified 22 14%
Student > Postgraduate 21 14%
Student > Ph. D. Student 19 13%
Other 42 28%
Readers by discipline Count As %
Medicine and Dentistry 69 45%
Unspecified 31 20%
Social Sciences 12 8%
Psychology 11 7%
Nursing and Health Professions 11 7%
Other 18 12%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 March 2015.
All research outputs
#10,995,334
of 12,372,945 outputs
Outputs from BMC Health Services Research
#3,794
of 4,083 outputs
Outputs of similar age
#184,465
of 220,970 outputs
Outputs of similar age from BMC Health Services Research
#3
of 4 outputs
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