June 11, 2018Journal of Comparative Effectiveness Research37 citations

Evaluation of antihypertensive adherence and its determinants at primary healthcare facilities in rural South Africa

EREnos M Rampamba JMJohanna C. Meyer BGBrian Godman

Structured PICO

Population

251 black hypertensive patients, ≥ 18 years, on chronic antihypertensive treatment for more than 6 months, recruited from 50 primary healthcare facilities in rural Vhembe District, South Africa. Mean age 63 years, 82.4% female.

Outcome

Adherence to antihypertensive treatment assessed via patient self-reporting using a 6-category scale over the past 30 dayspatient reported

Self-reported adherence to antihypertensive therapy in rural South Africa is suboptimal at 54.6%, though adherence is significantly associated with better blood pressure control.

Limitations

Subjective measures of adherence with increased probability that patients provide answers that conform to perceived expectations
Patients had similar demographic characteristics and experiences
Sample size and the number of variables measured

Abstract

AIM: To evaluate adherence to antihypertensive treatment in rural South Africa and identify potential determinants given concerns with adherence and its impact in this priority disease area. Patients odds ratios OR = 2.1; 95% CI: 1.1, 3.8; p = 0.019), comorbidity (OR = 2.0; 95% CI: 1.1, 3.6; p = 0.032) and smoking (OR = 0.3; 95% CI: 0.1, 0.8; p = 0.018) were associated with adherence. CONCLUSION: Adherence and BP control were suboptimal, only smoking was an independent risk factor for adherence. Adherent patients were twice as likely to have controlled BP, although results were sensitive to the definition of adherence. Initiatives are in place to improve adherence, which will be monitored.

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