How hypertensive patients in the rural areas use home blood pressure monitoring and its relationship with medication adherence: A primary care survey in China

Abstract

Despite an increasing popularity of home blood pressure monitoring (HBPM) over the last few decades, little is known about HBPM use among hypertensive patients in the rural areas. A crosssectional survey including 318 hypertensive patients was conducted in a rural community in Beijing, China, in 2012. Participants were mainly recruited from a community health clinic and completed the questionnaires assessing HBPM usage. Binary logistic regression models were used for the analysis of medication adherence with age, gender, level of education marital status, perceived health status, duration of hypertension, HBPM use, and frequency of performing BP measurement. Among the total population, 78 (24.5%) reported currently use of HBPM. Only 5.1% of the HBPM users cited doctor's advice as the reason for using HBPM. Analysis of the risk factors of poor medication adherence by multivariable modeling indicated significant associations between the duration of hypertension (adjusted OR, 3.31; 95% CI, 1.91 -5.72; P < 0.001), frequency of performing BP measurements (adjusted OR, 2.33; 95% CI, 1.42 -3.83; P < 0.001) and medication adherence. We found that most use of HBPM was without the involvement of a doctor or nurse. Further study is required to understand if HBPM is effective and the role of health professionals in its use for improved hypertension control.

Hypertension Knowledge and Willingness of Government Officials in a Southwestern Nigerian City to Self-Monitor Blood Pressure

“…A little below average claimed that they did not have the required knowledge on how to use the instrument even if they can afford it and that will definitely prevent them from selfmonitoring their BP. These align with the findings by Rahman et al 29 and Hu et al 30 who reported that cost, perceived complexity of the procedure, lack of knowledge and skills to use the BP monitoring devices, belief that pressure readings may be inaccurate, and anxiety from being diagnosed with hypertension/a constant reminder of their conditions and the financial burden that may be imposed by HBP management are factors militating against SMBP. 29,30 The poor attitude toward self-monitoring of the BP may be due to inadequate educational programs, especially as it relates with the prevention of hypertension.…”

“…This high enthusiasm may be as a result of the fact that majority of the respondents are young and educated because a previous study reported that people with a higher education level, higher income, and younger age were more likely to adopt self-monitoring BP. 30 Most of the respondents had favorable attitude and were willing to be trained to selfmonitor their BP. This is also in line with the findings by Carter et al 32 Training is important to equip individuals with skills to be able to measure the BP readings correctly.…”

“…30 who reported that cost, perceived complexity of the procedure, lack of knowledge and skills to use the BP monitoring devices, belief that pressure readings may be inaccurate, and anxiety from being diagnosed with hypertension/a constant reminder of their conditions and the financial burden that may be imposed by HBP management are factors militating against SMBP. 29,30 The poor attitude toward self-monitoring of the BP may be due to inadequate educational programs, especially as it relates with the prevention of hypertension. 31 These findings are grave and indicate an urgent need for more educational interventions to improve the attitude and self-efficacy of respondents toward SBPM.…”

A Systematic Review of Factors Influencing Medication Adherence to Hypertension Treatment in Developing Countries

“…Lower levels of adherence in elderly patients with longer duration of antihypertensive therapy were also found in Serbia [28]. On the other hand, patients with shorter duration of hypertension were less likely to be adherent to treatment in Pakistan (<5 years) (AOR = 0.11, 95% CI: 0.013 -0.955) [44] and China (<3 years) (AOR = 3.31; 95% CI: 1.91 -5.72; P < 0.001) [56].…”