Barriers to and Facilitators of Hypertension Management in Asmara, Eritrea: Patients' Perspectives

Overview

Journal J Health Popul Nutr

Publisher Biomed Central

Specialties Nutritional Sciences
Public Health

Date 2017 Apr 15

PMID 28407794

Citations 26

Authors

Merhawi Teklezgi Gebrezgi

Mary Jo Trepka

Eyob Azaria Kidane

Affiliations

Soon will be listed here.

Abstract

Background: Personal hypertension management is a cornerstone in the prevention of hypertension complications. In Eritrea, the increase in the national life expectancy rate has been accompanied by an increase in hypertension complications such as stroke. Hence, this study was designed to identify barriers and facilitates to hypertension management from the perspective of the patients.

Methods: This was a qualitative study of a total of 48 individual in-depth interviews and two focus group discussions. It was conducted among hypertensive patients who were attending outpatient services at two hospitals in Asmara, Eritrea.

Results: This study identified barriers and facilitators of hypertension management related to the individual patient, family and community, and healthcare system. With respect to individual factors, economic barriers, stress, non-adherence to medications due to the use of traditional remedies, and difficulties and misconceptions about following physical activity guidelines were mentioned as barriers to hypertension management. Related to the community and healthcare system, low community awareness, community stigma, and inadequate health promotion materials were stated as barriers. Individual knowledge, family, and government support were reported as very important factors to the patient's success in the personal hypertension management.

Conclusions: Counseling patients about adherence to medication, strengthening family and government support, and empowering families and the community with appropriate knowledge of hypertension management could potentially help in an individual's adherence.

Citing Articles

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Li Q, Jiang J, Duan A, Hu J, Li L, Chen W BMC Public Health. 2024; 24(1):2826.

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References

Kearney P, Whelton M, Reynolds K, Muntner P, Whelton P, He J . Global burden of hypertension: analysis of worldwide data. Lancet. 2005; 365(9455):217-23. DOI: 10.1016/S0140-6736(05)17741-1. View

Balla S, Abdalla A, Elmukashfi T, Ahmed H . Hypertension among rural population in four states: Sudan 2012. Glob J Health Sci. 2014; 6(3):206-12. PMC: 4825233. DOI: 10.5539/gjhs.v6n3p206. View

Amira O, Okubadejo N . Frequency of complementary and alternative medicine utilization in hypertensive patients attending an urban tertiary care centre in Nigeria. BMC Complement Altern Med. 2007; 7:30. PMC: 2045097. DOI: 10.1186/1472-6882-7-30. View

Kotchen T . Hypertension control: trends, approaches, and goals. Hypertension. 2006; 49(1):19-20. DOI: 10.1161/01.HYP.0000250394.05703.06. View

Assah F, Atanga E, Enoru S, Sobngwi E, Mbanya J . Community-based peer support significantly improves metabolic control in people with Type 2 diabetes in Yaoundé, Cameroon. Diabet Med. 2015; 32(7):886-9. DOI: 10.1111/dme.12720. View

Buabeng K, Matowe L, Plange-Rhule J . Unaffordable drug prices: the major cause of non-compliance with hypertension medication in Ghana. J Pharm Pharm Sci. 2004; 7(3):350-2. View

Mendis S, Al Bashir I, Dissanayake L, Varghese C, Fadhil I, Marhe E . Gaps in capacity in primary care in low-resource settings for implementation of essential noncommunicable disease interventions. Int J Hypertens. 2012; 2012:584041. PMC: 3517842. DOI: 10.1155/2012/584041. View

Al-Nozha M, Arafah M, Al-Mazrou Y, Al-Maatouq M, Khan N, Khalil M . Coronary artery disease in Saudi Arabia. Saudi Med J. 2004; 25(9):1165-71. View

Touyz R, Campbell N, Logan A, Gledhill N, Petrella R, Padwal R . The 2004 Canadian recommendations for the management of hypertension: Part III--Lifestyle modifications to prevent and control hypertension. Can J Cardiol. 2004; 20(1):55-9. View

10.

Bosu W . The prevalence, awareness, and control of hypertension among workers in West Africa: a systematic review. Glob Health Action. 2015; 8:26227. PMC: 4306751. DOI: 10.3402/gha.v8.26227. View

11.

Opie L, Seedat Y . Hypertension in sub-Saharan African populations. Circulation. 2005; 112(23):3562-8. DOI: 10.1161/CIRCULATIONAHA.105.539569. View

12.

Kannel W . Blood pressure as a cardiovascular risk factor: prevention and treatment. JAMA. 1996; 275(20):1571-6. View

13.

Shafiq N, Gupta M, Kumari S, Pandhi P . Prevalence and pattern of use of complementary and alternative medicine (CAM) in hypertensive patients of a tertiary care center in India. Int J Clin Pharmacol Ther. 2003; 41(7):294-8. DOI: 10.5414/cpp41294. View

14.

Mufunda J, Mebrahtu G, Usman A, Nyarango P, Kosia A, Ghebrat Y . The prevalence of hypertension and its relationship with obesity: results from a national blood pressure survey in Eritrea. J Hum Hypertens. 2005; 20(1):59-65. DOI: 10.1038/sj.jhh.1001924. View

15.

Risso-Gill I, Balabanova D, Majid F, Ng K, Yusoff K, Mustapha F . Understanding the modifiable health systems barriers to hypertension management in Malaysia: a multi-method health systems appraisal approach. BMC Health Serv Res. 2015; 15:254. PMC: 4489127. DOI: 10.1186/s12913-015-0916-y. View

16.

Karan A, Engelgau M, Mahal A . The household-level economic burden of heart disease in India. Trop Med Int Health. 2014; 19(5):581-91. DOI: 10.1111/tmi.12281. View

17.

Ataklte F, Erqou S, Kaptoge S, Taye B, Echouffo-Tcheugui J, Kengne A . Burden of undiagnosed hypertension in sub-saharan Africa: a systematic review and meta-analysis. Hypertension. 2014; 65(2):291-8. DOI: 10.1161/HYPERTENSIONAHA.114.04394. View

18.

Usman A, Mebrahtu G, Mufunda J, Nyarango P, Hagos G, Kosia A . Prevalence of non-communicable disease risk factors in Eritrea. Ethn Dis. 2007; 16(2):542-6. View

19.

Addo J, Smeeth L, Leon D . Hypertension in sub-saharan Africa: a systematic review. Hypertension. 2007; 50(6):1012-8. DOI: 10.1161/HYPERTENSIONAHA.107.093336. View

20.

Mufunda J, Nyarango P, Kosia A, Obgamariam A, Mebrahtu G, Usman A . Noncommunicable diseases in Africa: a silent hypertension epidemic in Eritrea. J Hum Hypertens. 2004; 19(3):255-6. DOI: 10.1038/sj.jhh.1001802. View