Adherence to Essential Hypertension Treatment Guidelines in a Tertiary Hospital in Nigeria

Abstract

Objective: This study determined the level of prescribers’ adherence to the World Health Organization/International Society of Hypertension (WHO/ISH) guidelines for the management of hypertension at the Lagos University Teaching Hospital (LUTH), Nigeria.
 Methods: This study employed a retrospective cross-sectional design. Two groups were used: Group A (300 patients) were treated before the guidelines review in 2003, while Group B (200 patients) were treated after. The two study groups were compared, and systolic blood pressure of 130 mm Hg or above was taken as the index of hypertension.
 Results: There were 198 (66%) male patients in Group A, while Group B had 136 (68%) males. The highest age for Group A was 50–59 y for 89 (30%) patients, unlike group B that had 58 (29%) patients in aged 40–49 y as the highest. The highest blood pressure range for patients in Group A was 150–159 mm Hg for 64 (21%) patients, unlike Group B that had 43 (22%) patients as the highest in the same range. Furosemide was present in 282 (24%) prescriptions for group A patients. However, atenolol was present in 61 (20%) prescriptions for the same group. In group B, Furosemide was prescribed in 197 (97%) encounters, while Nifedipine was found in 81(40%) prescriptions.
 Conclusion: Prescribers at LUTH complied substantially with WHO/ISH guidelines in the management of hypertension. Diuretics and beta-blockers were used before the guideline review. After the review, diuretics and calcium channel blockers were the most frequently prescribed antihypertensives.

Understanding Patient Adherence to Hypertension Management Guidelines

“…The ultimate goal is to bridge the gap between guideline recommendations and actual practice, enhancing both the delivery of healthcare and patient outcomes in the management of hypertension. This approach is aligned with the call for more personalized, patient-centered care strategies that consider the diverse needs and contexts of patients living with hypertension (Ibezim et al, 2020;Mulatu et al, 2022). Through this study, we contribute to the ongoing dialogue on improving hypertension management by providing a nuanced understanding of the factors that influence patient adherence to treatment guidelines.…”

“…The management of hypertension involves multifaceted strategies that encompass lifestyle modifications and adherence to prescribed medication regimes (Jarari et al, 2015;Ks et al, 2021;Midlöv et al, 2008;Milchak et al, 2006). Despite the critical importance of managing this condition, adherence to hypertension management guidelines by both healthcare providers and patients is less than optimal, leading to significant morbidity and mortality (Adedeji et al, 2015;Drawz et al, 2009;Edmealem et al, 2022;Ibezim et al, 2020).…”