What is the uptake of and factors associated with community blood pressure monitoring among people living with HIV and hypertension?
Uptake of community blood pressure monitoring among people living with HIV and hypertension in Uganda is low (27%) but can be significantly improved through provider counseling, feedback, and access to BP devices.
Abstract Introduction: The World Health Organization recommends Community-based blood pressure monitoring (BPM) for diagnosis and management of hypertension. However, there is limited data on the uptake and factors associated with community BPM among people living with HIV (PLHIV) and hypertension in many low-income settings including Uganda. This study aimed to determine the uptake of, and factors associated with community BPM among PLHIV and hypertension receiving care at selected HIV clinics. Methods A cross-sectional study was conducted between May and July 2024 at three HIV clinics participating in an implementation trial (NCT05609513), registration date, November 8, 2022) in the Kampala and Wakiso districts. A total of 408 participants, proportionally distributed across the clinics, were randomly selected and surveyed using a pretested questionnaire. Descriptive statistics were performed, reporting means or medians with standard deviations (SD)/interquartile ranges (IQR) and frequencies with proportions for numerical and categorical variables, respectively. Factors associated with community BPM uptake were assessed using bi-variable and multivariable modified Poisson regression. Data analysis was performed using STATA 14.1 Results Of the 408 participants, 67.7% were female, mean age of 50.1 years (SD = 10.7). All participants had been on HIV and hypertension medications for a median duration of 5 years (IQR: 3.5–7.2) and 1 year (IQR 1–1), respectively. Community BPM uptake was 27% (95% CI: 23.3–32.0). Among those monitoring their BP in the community, 68.6% did so at private clinics, 70% at pharmacies, 15.2% at public health facilities, and 5.4% self-monitored their BP. Multivariable analysis indicated that the uptake of community BPM was associated with receiving three antihypertensive medications (adjusted prevalence ratio [aPR: 2.2, 95% CI: 1.1–4.4), receiving advice from healthcare providers (aPR: 8.7, 95% CI: 3.7–20.5), receiving feedback on BP monitoring (aPR: 33.3, 95% CI: 4.1–268.6), and owning a BP device (aPR: 2.2, 95% CI: 1.3–3.5). Conclusion Community BPM uptake among PLHIV and hypertension was low. However, individuals receiving healthcare provider recommendations and feedback, owning BP devices, or on three antihypertensive medications were more likely to engage in community BPM. To improve uptake and ensure continuity of care, targeted interventions such as healthcare provider counseling, feedback mechanisms, and facilitating access to BP devices are recommended.
Kiggundu et al. (Thu,) studied this question.