Blood pressure control and burden of treatment in South African primary healthcare: A cross-sectional study
Background: Poor blood pressure (BP) control has been associated with high burden of treatment (BOT) in several settings. It is not known whether this relationship holds true for South African primary care. Aim: The aim of this study was to assess BOT and determine its relationship with BP control a...
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Format: | Article |
Language: | English |
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AOSIS
2019-12-01
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Series: | African Journal of Primary Health Care & Family Medicine |
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Online Access: | https://phcfm.org/index.php/phcfm/article/view/2110 |
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author | Kevin Pender Olufemi Omole |
author_facet | Kevin Pender Olufemi Omole |
author_sort | Kevin Pender |
collection | DOAJ |
description | Background: Poor blood pressure (BP) control has been associated with high burden of treatment (BOT) in several settings. It is not known whether this relationship holds true for South African primary care.
Aim: The aim of this study was to assess BOT and determine its relationship with BP control amongst patients with hypertension in a large community health centre, south of Johannesburg.
Setting: The setting of this study was carried out in the OPD of Johan Heyns Community Health Center.
Methods: A cross-sectional study involving 239 patients with hypertension was carried out. Information on sociodemography and BP readings in the last 3 months were extracted from patient medical records. A researcher-administered treatment burden questionnaire was also used to collect information on participants’ perceptions of BOT relating to medication regimen, navigating the healthcare system and life style changes and/or social and/or financial issues. Total BOT (TBOT) was determined as the sum of the scores in the three components and categorised as 1–45 = low, 46–90 = moderate and 91–140 = high. Analysis included descriptive statistics and test of association.
Results: Most participants were white (54.2%), 55 years (52.9%), female (60.1%), married (56.3%), had grade 12 or more education (71.9%) and had no comorbidity (56.7%). The mean duration of hypertension treatment was 113.8 months and most participants were uncontrolled (60.1%). Most participants (75%) reported a low TBOT score, with a mean of 19.7. Amongst participants with clinical comorbidities, most (66.3%) did not consider hypertension to be more burdensome than other comorbid illnesses. There was no significant association between TBOT and BP control (p = 0.53). However, participants with a high BOT relating to medication regimen were significantly more likely to be uncontrolled (p = 0.04).
Conclusion: Total BOT is low amongst study participants and has no significant influence on BP control. However, improvements in BP control in South African primary healthcare may be hinged on interventions that address problems associated with hypertension medication regimen. |
first_indexed | 2024-04-12T02:10:45Z |
format | Article |
id | doaj.art-fa8c9c57e3be4ec7bf887886830f1df3 |
institution | Directory Open Access Journal |
issn | 2071-2928 2071-2936 |
language | English |
last_indexed | 2024-04-12T02:10:45Z |
publishDate | 2019-12-01 |
publisher | AOSIS |
record_format | Article |
series | African Journal of Primary Health Care & Family Medicine |
spelling | doaj.art-fa8c9c57e3be4ec7bf887886830f1df32022-12-22T03:52:24ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362019-12-01111e1e710.4102/phcfm.v11i1.2110683Blood pressure control and burden of treatment in South African primary healthcare: A cross-sectional studyKevin Pender0Olufemi Omole1Division of Family Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,Division of Family Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,Background: Poor blood pressure (BP) control has been associated with high burden of treatment (BOT) in several settings. It is not known whether this relationship holds true for South African primary care. Aim: The aim of this study was to assess BOT and determine its relationship with BP control amongst patients with hypertension in a large community health centre, south of Johannesburg. Setting: The setting of this study was carried out in the OPD of Johan Heyns Community Health Center. Methods: A cross-sectional study involving 239 patients with hypertension was carried out. Information on sociodemography and BP readings in the last 3 months were extracted from patient medical records. A researcher-administered treatment burden questionnaire was also used to collect information on participants’ perceptions of BOT relating to medication regimen, navigating the healthcare system and life style changes and/or social and/or financial issues. Total BOT (TBOT) was determined as the sum of the scores in the three components and categorised as 1–45 = low, 46–90 = moderate and 91–140 = high. Analysis included descriptive statistics and test of association. Results: Most participants were white (54.2%), 55 years (52.9%), female (60.1%), married (56.3%), had grade 12 or more education (71.9%) and had no comorbidity (56.7%). The mean duration of hypertension treatment was 113.8 months and most participants were uncontrolled (60.1%). Most participants (75%) reported a low TBOT score, with a mean of 19.7. Amongst participants with clinical comorbidities, most (66.3%) did not consider hypertension to be more burdensome than other comorbid illnesses. There was no significant association between TBOT and BP control (p = 0.53). However, participants with a high BOT relating to medication regimen were significantly more likely to be uncontrolled (p = 0.04). Conclusion: Total BOT is low amongst study participants and has no significant influence on BP control. However, improvements in BP control in South African primary healthcare may be hinged on interventions that address problems associated with hypertension medication regimen.https://phcfm.org/index.php/phcfm/article/view/2110blood pressurecontrolburden of treatmentprimary healthcareissues around medication regimennavigating healthcare system |
spellingShingle | Kevin Pender Olufemi Omole Blood pressure control and burden of treatment in South African primary healthcare: A cross-sectional study African Journal of Primary Health Care & Family Medicine blood pressure control burden of treatment primary healthcare issues around medication regimen navigating healthcare system |
title | Blood pressure control and burden of treatment in South African primary healthcare: A cross-sectional study |
title_full | Blood pressure control and burden of treatment in South African primary healthcare: A cross-sectional study |
title_fullStr | Blood pressure control and burden of treatment in South African primary healthcare: A cross-sectional study |
title_full_unstemmed | Blood pressure control and burden of treatment in South African primary healthcare: A cross-sectional study |
title_short | Blood pressure control and burden of treatment in South African primary healthcare: A cross-sectional study |
title_sort | blood pressure control and burden of treatment in south african primary healthcare a cross sectional study |
topic | blood pressure control burden of treatment primary healthcare issues around medication regimen navigating healthcare system |
url | https://phcfm.org/index.php/phcfm/article/view/2110 |
work_keys_str_mv | AT kevinpender bloodpressurecontrolandburdenoftreatmentinsouthafricanprimaryhealthcareacrosssectionalstudy AT olufemiomole bloodpressurecontrolandburdenoftreatmentinsouthafricanprimaryhealthcareacrosssectionalstudy |