Barriers and facilitators to treatment among patients with newly diagnosed hypertension in Nepal

Abstract

A number of factors emerged as barriers and facilitators to hypertension treatment. This information can be useful in designing appropriate health interventions to improve hypertension management.

Barriers, enablers and strategies for the treatment and control of hypertension in Nepal: a mixed-methods systematic review

“…No additional eligible studies were found in Nepalese journals and on websites of the Nepali Government, professional and regulatory organisation, and national and international agencies. Finally, we included 14 studies [43][44][45][46][47][48][49][50][51][52][53][54][55][56] for qualitative synthesis (see Fig 2). None of the studies were included in the quantitative synthesis of effect sizes because of the signi cant differences in their aims, methods, interventions/exposures and outcome measures.…”

“…Only a study conducted in Acham (hospital and community-based) included participants from a rural area [47]. Half of the studies were completed in 2015 or later; and more than half of the studies assessed the barriers and enablers of hypertension treatment and control [51][52][53][54][55][56]. They applied qualitative methods (n=3) [52][53][54], quantitative methods (n=4) [51,56] and mixed methods (n=1) [55].…”

“…We categorised them into three major domains: HS excluding provider and patient , providers and individual-level barriers (see Table 3). The unaffordability of health services [52], lack of human resources (primarily in rural areas) [54] and the unavailability of diagnostic tools [54] were the most often cited HS barriers.…”

“…I am following the same regimen from last one and a half years. My doctor told me to visit him only if I had problems" [55] In addition, other provider-related factors affecting hypertension treatment and control were: health worker's lack of interest in counselling for lifestyle modi cations [52][53][54][55]; long waiting hours for the appointment [52,55]; lack of national guidelines in hypertension treatment [55]; and provider's negative behaviours [52].…”

“…A wide variety of themes evolved from the qualitative analysis of the ndings on patient's beliefs and practices that affect hypertension treatment and control (table 3). The factors impeding initiation of anti-hypertensive treatment were poor help-seeking behaviours [54] and reluctance to take medication due to perceived side effects and fear of long-term use [52,55]. Other factors related mostly to treatment adherence and lack of routine monitoring of patients [54,55].…”