Key result
Fixed-dose combinations for hypertension are potentially acceptable to patients, caregivers, and healthcare workers in Kenya due to perceived reductions in treatment burden.
Why the study?
Fixed-dose combinations have the potential to improve hypertension treatment, but factors undermining their implementation remain unknown, particularly in sub-Saharan Africa.
Are fixed-dose combinations for hypertension acceptable to patients, caregivers, and healthcare workers in Kenya?
Observational (n=58)
Yes
Are fixed-dose combinations for hypertension acceptable to patients, caregivers, and healthcare workers in Kenya?
Fixed-dose combinations for hypertension are generally acceptable to patients and providers in Kenya, though successful implementation requires addressing provider knowledge gaps and systemic issues like availability and affordability.
May support piloting hypertension FDCs in Kenya; leaves open whether affordability and knowledge gaps limit uptake.
Fixed-dose combinations (FDCs) - 2-3 anti-hypertensive medications in a single pill - have the potential to improve hypertension treatment and outcomes. Yet, they are not widely implemented. Factors undermining implementation remain unknown, particularly in sub-Saharan Africa, where hypertension is a major cause of disease burden and is poorly controlled. This study explored the acceptability of FDCs among patients, caregivers, and healthcare workers. We conducted semi-structured in-depth interviews with 58 participants from four purposively selected health facilities in Kiambu county, Kenya. Data were analyzed using an iterative thematic analysis approach, guided by the Theoretical Framework of Acceptability. Our findings indicate that FDCs are potentially acceptable to all participant groups. Acceptability is supported by the perception of FDCs as a means of reducing treatment burden (for patients and healthcare workers) and improving treatment adherence, and by patients' deferral to and trust in healthcare workers. However, acceptability among healthcare workers may be undermined by variable levels of knowledge about FDCs, concerns about FDCs as an "inflexible" treatment that does not allow dose titration or identifying causes of side effects, and concerns about inconsistent availability and affordability of FDCs in Kenya. To enhance acceptability and implementation of FDCs for hypertension treatment in Kenya, it is crucial to strengthen the capacity of all healthcare worker cadres to appropriately prescribe, inform patients about, and support adherence to FDCs. These efforts must align with broader initiatives to address upstream health system factors such as poor availability and affordability.
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Mbuthia et al. (2025) conducted an observational in Hypertension (n=58). Fixed-dose combinations (FDCs) for hypertension vs. Multiple single-molecule pills was evaluated on Acceptability of FDCs. Fixed-dose combinations for hypertension are potentially acceptable to patients, caregivers, and healthcare workers in Kenya due to perceived reductions in treatment burden.
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