Patients’ Knowledge, Attitudes, Behaviour and Health Care Experiences on the Prevention, Detection, Management and Control of Hypertension in Colombia: A Qualitative Study

Abstract

Hypertension is a leading cause of premature death worldwide and the most important modifiable risk factor for cardiovascular disease. Effective screening programs, communication with patients, regular monitoring, and adherence to treatment are essential to successful management but may be challenging in health systems facing resource constraints. This qualitative study explored patients’ knowledge, attitudes, behaviour and health care seeking experiences in relation to detection, treatment and control of hypertension in Colombia. We conducted in-depth interviews and focus group discussions with 26 individuals with hypertension and 4 family members in two regions. Few participants were aware of ways to prevent high blood pressure. Once diagnosed, most reported taking medication but had little information about their condition and had a poor understanding of their treatment regime. The desire for good communication and a trusting relationship with the doctor emerged as key themes in promoting adherence to medication and regular attendance at medical appointments. Barriers to accessing treatment included co-payments for medication; costs of transport to health care facilities; unavailability of drugs; and poor access to specialist care. Some patients overcame these barriers with support from social networks, family members and neighbours. However, those who lacked such support, experienced loneliness and struggled to access health care services. The health insurance scheme was frequently described as administratively confusing and those accessing the state subsidized system believed that the treatment was inferior to that provided under the compulsory contributory system. Measures that should be addressed to improve hypertension management in Colombia include better communication between health care professionals and patients, measures to improve understanding of the importance of adherence to treatment, reduction of co-payments and transport costs, and easier access to care, especially in rural areas.

Não utilização de consultas de rotina na Atenção Básica por pessoas com hipertensão arterial

“…Such finding is corroborated by studies carried out in Colombia 23 , United States 24 and Brazil 15 . In the national study, for instance, individuals with SAH who had access to health plans were nearly three times more likely to attend medical consultations 15 .…”

“…Based on clinical practice and literature evidence 19,23 , it is believed that the presence alone of individuals at consultations is not enough for compliance with the treatment and for the reduction of BP rates. From this perspective, a study carried out in Colombia evidenced that individuals with SAH valued the work method applied, the activities developed at the health unit, the quality of the care provided and the quality of interpersonal relationships and communication established between professional and patient, as the main factors that led patients to stick to consultations 23 . In this sense, in order to increase rates of use of routine consultations in PC, healthcare professionals should consider, during their practice, the aforementioned aspects.…”

Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries

“…Those completed so far reveal complex pictures relating to both demand for treatment, influenced by cost of drugs and by how hypertension – a chronic, asymptomatic, but hazardous condition – is conceptualized, and by supply of trained health professionals and medicines [34, 35]. Other data from the Environmental Profile of a Community’s Health study (EPOCH), nested within PURE, also provide insights.…”

Knowledge, attitudes and practices of hypertensive patients towards prevention and early detection of chronic kidney disease: a cross sectional study from Palestine

“…Usually patients who are diagnosed with hypertension are prescribed medications to manage their disease, yet they know only a little about it and its complications. Effective screening methods, better communication with patients, frequent check-ups and compliance to drugs and healthy practices are all essential to achieve success in management but unfortunately these are actually real challenges [8]. Moreover studies showed that many of the hypertensive patients forget to take the prescribed medication occasionally thus emphasizing the great role of communication strategies of health professionals and the necessity of improving doctor-patient relationship [9].…”