Key result
Continuous patient education was ranked as the most desirable strategy to promote hypertension adherence (54 scores), followed by a national dashboard for medication stock (52 scores) and community support groups (49 scores).
Why the study?
To determine the most acceptable hypertension intervention package to promote medication adherence based on stakeholders' perspectives.
A multifaceted educational intervention package targeting patient knowledge, drug availability, and social support is considered the most acceptable strategy to promote hypertension medication adherence in Namibia.
Stakeholder-derived hypertension adherence packages require validation in trials; leaves open their effect on blood pressure control.
OBJECTIVE: To determine the most acceptable hypertension intervention package to promote hypertension adherence based on stakeholders' perspectives. DESIGN: We employed the nominal group technique method and purposively sampled and invited key stakeholders offering hypertension services and patients with hypertension. Phase 1 was focused on determining barriers to hypertension adherence, phase 2 on enablers and phase 3 on the strategies. We employed the ranking method based on a maximum of 60 scores to establish consensus regarding hypertension adherence barriers, enablers and proposed strategies. SETTING AND PARTICIPANTS: 12 key stakeholders were identified and invited to participate in the workshop in Khomas region. Key stakeholders included subject matter experts in non-communicable diseases, family medicine and representatives of our target population (hypertensive patients). RESULTS: The stakeholders reported 14 factors as barriers and enablers to hypertension adherence. The most important barriers were: lack of knowledge on hypertension (57 scores), unavailability of drugs (55 scores) and lack of social support (49 scores). Patient education emerged as the most important enabler (57 scores), availability of drugs emerged second (53 scores) and third having a support system (47 scores). Strategies were 17 and ranked as follows: continuous patient education as the most desirable (54 scores) strategy to help promote hypertension adherence, followed by developing a national dashboard to primarily monitor stock (52 scores) and community support groups for peer counselling (49 scores). CONCLUSIONS: Multifaceted educational intervention package targeting patient and healthcare system factors may be considered in implementing Namibia's most acceptable hypertension package. These findings will offer an opportunity to promote adherence to hypertension therapy and reduce cardiovascular outcomes. We recommend a follow-up study to evaluate the proposed adherence package's feasibility.
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Nakwafila et al. (2023) studied Hypertension (n=12). Stakeholder perspectives on hypertension adherence interventions was evaluated on Ranking of acceptable strategies for hypertension adherence. Continuous patient education was ranked as the most desirable strategy to promote hypertension adherence (54 scores), followed by a national dashboard for medication stock (52 scores) and community support groups (49 scores).
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