Illness Perception Among Patients With Hypertension in Nepal

Maharjan, Safala; Chinnawong, Tippamas; Kritpracha, Charuwan

doi:10.5176/2345-718x_4.2.148

Cited by 7 publications

(24 citation statements)

References 10 publications

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“…Only one study discussed enablers separately. The study found that scores of dimensions of illness perception particularly timeline, treatment control and coherence were positively correlated with medication adherence [42]. The higher the participant perceived high blood pressure as a chronic condition (Spearman correlation coefficient (r)=0.23, p<0.05), the better was medication adherence.…”

Section: Analysis Of Quantitative Studiesmentioning

confidence: 93%

“…Out of 106 full-text articles that we assessed, 94 had either ineligible outcomes, were conducted among non-hypertensive or non-Nepali participants, or were reviews, case reports or conference abstracts. We did the forward and backward citation tracking for the remaining 12 studies and identified two additional records [41,42]. Finally, we included 14 studies [41][42][43][44][45][46][47][48][49][50][51][52][53][54] for qualitative synthesis (see Fig 2).…”

Section: Study Selectionmentioning

confidence: 99%

“…We did the forward and backward citation tracking for the remaining 12 studies and identified two additional records [41,42]. Finally, we included 14 studies [41][42][43][44][45][46][47][48][49][50][51][52][53][54] for qualitative synthesis (see Fig 2). None of the studies were included in the quantitative synthesis of effect sizes because of the significant differences in their aims, methods, interventions/exposures and outcome measures.…”

Section: Study Selectionmentioning

confidence: 99%

“…The more the participant believed that treatment can control the blood pressure (r=0.51, p<0.05), the higher the medication adherence score they had. The better the understanding of hypertension (coherence, r=0.22, p<0.05), the higher was the medication adherence [42].…”

Section: Analysis Of Quantitative Studiesmentioning

confidence: 99%

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

Dhungana

Pandey

Shrestha

et al. 2020

Preprint

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Background Untreated and uncontrolled hypertension are major challenges in the cascade of care of hypertension in Nepal. The challenge of achieving effective treatment and control of blood pressure is linked to various barriers to hypertension care at different layers of health system. Evidence is emerging globally on the effectiveness of multi-pronged hypertension control strategies, including health system strengthening and population-based interventions. However, no systematic review of the strategies of and factors associated with hypertension treatment and control in Nepal is available. Understanding country-specific factors influencing hypertension care is critical to address the gaps in the management of hypertension. This study, therefore, aimed to systematically review published literature and synthesise the findings on barriers, enablers and strategies for hypertension treatment and control in Nepal. Methods Six databases namely Embase, PubMed, Web of Science, CINAHL (through EBSCOHost), ProQuest and WorldCat were systematically searched for studies investigating the factors or strategies in relation to hypertension treatment and control in Nepal. The methodological quality of selected articles was assessed using Mixed Methods Appraisal Tool (MMAT). Themes on barriers and enablers were generated and framed under “health system excluding provider and patient (HS)”, “provider” and “patient” domains, according to the framework synthesis approach. Findings on hypertension strategies were narratively synthesised. Results We identified 14 published studies; one with mixed, three with qualitative and 10 with quantitative methods, eight relating to barriers and enablers and six of hypertension strategies. The identified barriers associated with the health system (HS) were: lack of affordable services and lack of resources. The commonly reported barriers at the provider’s level were: lack of clear instructions from the providers for medication use, follow-up visits and lifestyle modifications, and long waiting hours for appointments. Poor help-seeking behaviour, non-adherence to medication, perceived side-effects of drugs, financial hardship and lack of family support were barriers identified at patient level. The following enablers were identified: positive illness perception, free essential healthcare services and family support. Strategies implemented across the HS, provider and patient were: establishing digital health records at health centres, health worker’s capacity development, health education and yoga practice. Conclusion There is a range of barriers for hypertension treatment and control in Nepal pertaining to the health system, providers, and patients. Comprehensive interventions are needed at all three levels to further improve management and control of hypertension in Nepal.

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Section: Analysis Of Quantitative Studiesmentioning

confidence: 93%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Analysis Of Quantitative Studiesmentioning

confidence: 99%

See 2 more Smart Citations

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

Dhungana

Pandey

Shrestha

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…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.…”

Section: Study Selectionmentioning

confidence: 99%

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

Dhungana

Pedišić

Pandey

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The challenge of achieving effective treatment and control of blood pressure is linked to various barriers to hypertension care at different layers of health system (HS). Evidence is emerging globally on the effectiveness of multi-pronged hypertension control strategies. However, no systematic review of strategies of and factors associated with hypertension treatment and control in Nepal is available. Understanding country-specific factors influencing hypertension care is critical to address the gaps in the management of hypertension. This study aimed to systematically review published literature and synthesise the findings on barriers, enablers and strategies for hypertension treatment and control in Nepal. Methods: Six databases namely Embase, PubMed, Web of Science, CINAHL, ProQuest and WorldCat, Nepali journals and Nepal government websites were systematically searched for qualitative, quantitative and mixed-methods studies investigating the factors or strategies in relation to hypertension treatment and control in Nepal. The methodological quality of selected articles was assessed using Mixed Methods Appraisal Tool. Themes on barriers and enablers were generated and framed under “health system” , “provider” and “patient” domains, according to the framework synthesis approach. Findings on hypertension strategies were narratively synthesised. Results: We identified 14 published studies; one with mixed, three with qualitative and 10 with quantitative methods. Eight were related to barriers and enablers and six of hypertension strategies. The identified barriers associated with the HS were: lack of affordable services and lack of resources. The barriers at the provider’s level were: communication gaps and long waiting hours for appointments. Poor help-seeking behaviour, non-adherence to medication, perceived side-effects of drugs, financial hardship and lack of family support were barriers identified at patient level. The following enablers were identified: positive illness perception, free essential healthcare services and family support. Strategies implemented across the HS, provider and patient were: establishing digital health records at health centres, health worker’s capacity development, health education and yoga practice. Conclusion: There is a range of barriers for hypertension treatment and control in Nepal pertaining to the HS, providers, and patients. Comprehensive interventions are needed at all three levels to further improve management and control of hypertension in Nepal.Registration: The protocol is registered in PROSPERO (registration number: CRD42020145823)

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Adherence to Antihypertensive Treatment and Associated Factors in Central Ethiopia

Daniel

Tsadik

Berhane

et al. 2020

International Journal of Hypertension

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Background. Adherence to treatment is a primary determinant of treatment success. Nonadherence attenuates clinical benefits to the recipients of the treatment. However, monitoring adherence to long treatment regimens is not given due emphasis in low-income contexts. This study aimed to assess adherence to antihypertensive treatment and factors associated with it in Central Ethiopia. Method. This is an institution-based cross-sectional study conducted in 4 public hospitals in Central Ethiopia from December 4, 2016, to September 25, 2017. The Morisky Medication Adherence Scale (MMAS-8) was used to assess the level of adherence. The Revised Illness Perception Questionnaire (IPQ-R) was used to assess illness perception. The MMAS-8 score ranges from 0 to 8, a score of 8 reflects high adherence, 6 to 7 medium adherence, and <6 low adherence. Results. A total of 989 hypertensive patients participated in the study, of which 36.0% were assessed to have high adherence, 31.7% medium adherence, and 32.3% low adherence. We found that treatment adherence was significantly and positively associated with having family support (AOR: 1.65; 95% CI = 1.23, 2.22), high perception about consequences of hypertension (AOR: 1.51; 95% CI = 1.17, 1.95), and high perception about the severity of the disease (AOR: 1.42; 95% CI = 1.09, 1.86). Conclusion. The treatment adherence to antihypertensive medications is low in Central Ethiopia. Engaging family members in the treatment plan and improving patients’ understanding of the illness are critical in achieving high adherence to medication in this context.

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Illness Perception Among Patients With Hypertension in Nepal

Cited by 7 publications

References 10 publications

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

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

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

Adherence to Antihypertensive Treatment and Associated Factors in Central Ethiopia

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