Adherence Clubs to Improve Hypertension Management in Nigeria: Clubmeds, a Feasibility Study
Background: Hypertension control remains a significant challenge in reducing the cardiovascular disease burden worldwide. Community peer-support groups have been identified as a promising strategy to improve medication adherence and blood pressure (BP) control. Objectives: The study aimed to evaluat...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ubiquity Press
2022-03-01
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| Series: | Global Heart |
| Subjects: | |
| Online Access: | https://globalheartjournal.com/articles/1109 |
| _version_ | 1828784424275148800 |
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| author | Godsent C. Isiguzo Karla Santo Rajmohan Panda Lilian Mbau Shiva R. Mishra Collins N. Ugwu Salim S. Virani Augustine N. Odili Emily R. Atkins |
| author_facet | Godsent C. Isiguzo Karla Santo Rajmohan Panda Lilian Mbau Shiva R. Mishra Collins N. Ugwu Salim S. Virani Augustine N. Odili Emily R. Atkins |
| author_sort | Godsent C. Isiguzo |
| collection | DOAJ |
| description | Background: Hypertension control remains a significant challenge in reducing the cardiovascular disease burden worldwide. Community peer-support groups have been identified as a promising strategy to improve medication adherence and blood pressure (BP) control. Objectives: The study aimed to evaluate the feasibility and impact of adherence clubs to improve BP control in Southeast Nigeria. Methods: This was a mixed-methods research involving a formative (pre-implementation) research, pilot study and process evaluation. Hypertensive patients in two communities were recruited into peer-support adherence clubs under the leadership of role-model patients to motivate and facilitate medication adherence, BP monitoring, and monthly medication delivery for six months. The primary outcome was medication adherence measured using visual analogue scale (VAS), with BP level at six months as a key secondary outcome. Results: We recruited a total of 104 participants. The mean age was 56.8 (SD–10.7) years, 72 (69.2%) were women, mean BP was 146.7 (SD–20.1)/86.9 (SD–11.2) mmHg, and the mean percentage of medication adherence on the VAS was 41.4% (SD–11.9%). At six months, 67 patients were assessed; self-reported adherence on the VAS increased to 57.3% (SD–25.3%) (mean difference between baseline and follow-up of 15.5%, p < 0.0001), while the mean BP decreased to 132.3 (SD–22.0)/82.9 (SD–12.2) mmHg (mean difference of 13.0 mmHg in systolic BP, p < 0.0001 and of 3.6 mmHg in diastolic BP, p = 0.02). Five in-depth interviews and four focus groups discussions were conducted as part of the qualitative analyses of the study. The participants saw hypertension as a big issue, with many unaware of the diagnosis, and they accepted the CLUBMEDS differential service delivery (DSD) model concept in hypertension. Conclusions: The study demonstrates that the implementation of adherence clubs for hypertension control is feasible and led to a statistically significant and clinically meaningful improvement in self-reported medication adherence, resulting in BP reduction. Upscaling the intervention may be needed to confirm these findings. |
| first_indexed | 2024-12-11T23:31:27Z |
| format | Article |
| id | doaj.art-6eeca8682f7d424382d68a3018690835 |
| institution | Directory Open Access Journal |
| issn | 2211-8179 |
| language | English |
| last_indexed | 2024-12-11T23:31:27Z |
| publishDate | 2022-03-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | Global Heart |
| spelling | doaj.art-6eeca8682f7d424382d68a30186908352022-12-22T00:46:02ZengUbiquity PressGlobal Heart2211-81792022-03-0117110.5334/gh.1109928Adherence Clubs to Improve Hypertension Management in Nigeria: Clubmeds, a Feasibility StudyGodsent C. Isiguzo0Karla Santo1Rajmohan Panda2Lilian Mbau3Shiva R. Mishra4Collins N. Ugwu5Salim S. Virani6Augustine N. Odili7Emily R. Atkins8Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki; College of Medicine, Ebonyi State University AbakalikiWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney; The George Institute for Global Health, University of New South Wales, SydneyPublic Health Foundation of India, New DelhiKenya Cardiac Society, NairobiThe University of Queensland, Brisbane, AU; Nepal Development Society, BharatpurAlex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki; College of Medicine, Ebonyi State University AbakalikiMichael E. DeBakey Veterans Affairs Medical Center & Baylor College of Medicine, HoustonCirculatory Health Research Laboratory, College of Health Sciences, University of Abuja, AbujaWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney; The George Institute for Global Health, University of New South Wales, SydneyBackground: Hypertension control remains a significant challenge in reducing the cardiovascular disease burden worldwide. Community peer-support groups have been identified as a promising strategy to improve medication adherence and blood pressure (BP) control. Objectives: The study aimed to evaluate the feasibility and impact of adherence clubs to improve BP control in Southeast Nigeria. Methods: This was a mixed-methods research involving a formative (pre-implementation) research, pilot study and process evaluation. Hypertensive patients in two communities were recruited into peer-support adherence clubs under the leadership of role-model patients to motivate and facilitate medication adherence, BP monitoring, and monthly medication delivery for six months. The primary outcome was medication adherence measured using visual analogue scale (VAS), with BP level at six months as a key secondary outcome. Results: We recruited a total of 104 participants. The mean age was 56.8 (SD–10.7) years, 72 (69.2%) were women, mean BP was 146.7 (SD–20.1)/86.9 (SD–11.2) mmHg, and the mean percentage of medication adherence on the VAS was 41.4% (SD–11.9%). At six months, 67 patients were assessed; self-reported adherence on the VAS increased to 57.3% (SD–25.3%) (mean difference between baseline and follow-up of 15.5%, p < 0.0001), while the mean BP decreased to 132.3 (SD–22.0)/82.9 (SD–12.2) mmHg (mean difference of 13.0 mmHg in systolic BP, p < 0.0001 and of 3.6 mmHg in diastolic BP, p = 0.02). Five in-depth interviews and four focus groups discussions were conducted as part of the qualitative analyses of the study. The participants saw hypertension as a big issue, with many unaware of the diagnosis, and they accepted the CLUBMEDS differential service delivery (DSD) model concept in hypertension. Conclusions: The study demonstrates that the implementation of adherence clubs for hypertension control is feasible and led to a statistically significant and clinically meaningful improvement in self-reported medication adherence, resulting in BP reduction. Upscaling the intervention may be needed to confirm these findings.https://globalheartjournal.com/articles/1109blood pressure-loweringadherence clubsafricaprimary caremedicines access |
| spellingShingle | Godsent C. Isiguzo Karla Santo Rajmohan Panda Lilian Mbau Shiva R. Mishra Collins N. Ugwu Salim S. Virani Augustine N. Odili Emily R. Atkins Adherence Clubs to Improve Hypertension Management in Nigeria: Clubmeds, a Feasibility Study Global Heart blood pressure-lowering adherence clubs africa primary care medicines access |
| title | Adherence Clubs to Improve Hypertension Management in Nigeria: Clubmeds, a Feasibility Study |
| title_full | Adherence Clubs to Improve Hypertension Management in Nigeria: Clubmeds, a Feasibility Study |
| title_fullStr | Adherence Clubs to Improve Hypertension Management in Nigeria: Clubmeds, a Feasibility Study |
| title_full_unstemmed | Adherence Clubs to Improve Hypertension Management in Nigeria: Clubmeds, a Feasibility Study |
| title_short | Adherence Clubs to Improve Hypertension Management in Nigeria: Clubmeds, a Feasibility Study |
| title_sort | adherence clubs to improve hypertension management in nigeria clubmeds a feasibility study |
| topic | blood pressure-lowering adherence clubs africa primary care medicines access |
| url | https://globalheartjournal.com/articles/1109 |
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