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Devkota S, Dhungana RR, Pandey AR, et al. Barriers to Treatment and Control of Hypertension among Hypertensive Participants: A Community-Based Cross-sectional Mixed Method Study in Municipalities of Kathmandu, Nepal. Front Cardiovasc Med. 2016;3:26doi: 10.3389/fcvm.2016.00026.
Devkota, S., Dhungana, R. R., Pandey, A. R., Bista, B., Panthi, S., Thakur, K. K., & Gajurel, R. M. (2016). Barriers to Treatment and Control of Hypertension among Hypertensive Participants: A Community-Based Cross-sectional Mixed Method Study in Municipalities of Kathmandu, Nepal. Frontiers in cardiovascular medicine, 326. https://doi.org/10.3389/fcvm.2016.00026
Devkota, Surya, et al. "Barriers to Treatment and Control of Hypertension among Hypertensive Participants: A Community-Based Cross-sectional Mixed Method Study in Municipalities of Kathmandu, Nepal." Frontiers in cardiovascular medicine vol. 3 (2016): 26. doi: https://doi.org/10.3389/fcvm.2016.00026
Devkota S, Dhungana RR, Pandey AR, Bista B, Panthi S, Thakur KK, Gajurel RM. Barriers to Treatment and Control of Hypertension among Hypertensive Participants: A Community-Based Cross-sectional Mixed Method Study in Municipalities of Kathmandu, Nepal. Front Cardiovasc Med. 2016 Aug 02;3:26. doi: 10.3389/fcvm.2016.00026. eCollection 2016. PMID: 27532038; PMCID: PMC4969292.
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Front Cardiovasc Med. 2016 Aug 02;3:26. doi: 10.3389/fcvm.2016.00026. eCollection 2016.

Barriers to Treatment and Control of Hypertension among Hypertensive Participants: A Community-Based Cross-sectional Mixed Method Study in Municipalities of Kathmandu, Nepal.

Frontiers in cardiovascular medicine

Surya Devkota, Raja Ram Dhungana, Achyut Raj Pandey, Bihungum Bista, Savyata Panthi, Kartikesh Kumar Thakur, Ratna Mani Gajurel

Affiliations

  1. Manmohan Cardiothoracic, Vascular and Transplant Centre, Institute of Medicine, Tribhuvan University , Kathmandu , Nepal.
  2. Nepal Family Development Foundation , Kathmandu , Nepal.
  3. Nepal Health Research Council , Kathmandu , Nepal.
  4. Nature Care Hospital , Kathmandu , Nepal.

PMID: 27532038 PMCID: PMC4969292 DOI: 10.3389/fcvm.2016.00026

Abstract

INTRODUCTION: Despite the established evidence on benefits of controlling raised blood pressure and development of several guidelines on detection and management of hypertension, people often have untreated or uncontrolled hypertension. In this context, we undertook this study to identify the barriers existing in hypertension treatment and control in the municipalities of Kathmandu district in Nepal.

METHODS: This was a community based, cross-sectional mixed method study conducted in the municipalities of Kathmandu district in Nepal between January and July 2015. Among 587 randomly selected participants, the aware hypertensive participants were further assessed for the treatment and control of hypertension. For qualitative component, 20 participants having uncontrolled hypertension took part in two focused group discussions and two cardiac physicians participated in in-depth interviews.

RESULTS: Out of 587 participants screened, 191 (32.5%) were identified as hypertensive. Among 191 hypertensive participants, 118 (61.8%) were aware of their problem. Of the 118 aware hypertensive participants, 93 (78.8%) were taking medicines, and among those treated, 46 (49.6%) had controlled hypertension. Proportions of participants taking anti-hypertensive medications varied significantly with age groups, ethnicity, occupation and income. Hypertension control was significantly associated with use of combination therapy, adherence to medication, follow-up care, counseling by health-care providers, and waiting time in hospital. Being worried that the medicine needs to be taken lifelong, perceived side effects of drugs, non-adherence to medication, lost to follow-up, inadequate counseling from physician, and lack of national guidelines for hypertension treatment were the most commonly cited barriers for treatment and control of hypertension in qualitative component of the research.

CONCLUSION: Large proportion of the hypertensive population has the untreated and the uncontrolled hypertension. Efforts to dispel and dismantle the myths and barriers related to hypertension treatment and control are warranted to reduce the consequences of uncontrolled hypertension.

Keywords: Nepal; awareness; barriers; control; hypertension; treatment

References

  1. Ann Intern Med. 2014 Oct 21;161(8):568-78 - PubMed
  2. QJM. 2013 Oct;106(10):909-14 - PubMed
  3. Ther Clin Risk Manag. 2008 Feb;4(1):269-86 - PubMed
  4. J Manag Care Pharm. 2006 Apr;12(3):239-45 - PubMed
  5. BMJ. 2012 Jul 09;345:e3953 - PubMed
  6. JAMA. 2013 Sep 4;310(9):959-68 - PubMed
  7. Am Fam Physician. 2010 Feb 15;81(4):470-6 - PubMed
  8. J Hypertens. 2012 Aug;30(8):1500-10 - PubMed
  9. Can Fam Physician. 2007 Dec;53(12):2144-5 - PubMed
  10. Indian Heart J. 2006 Jan-Feb;58(1):34-7 - PubMed
  11. Int J Epidemiol. 2014 Feb;43(1):116-28 - PubMed
  12. PLoS One. 2014 Jan 15;9(1):e84238 - PubMed
  13. Circulation. 2007 Aug 28;116(9):1081-93 - PubMed
  14. Curr Med Res Opin. 2010 Aug;26(8):1881-91 - PubMed
  15. J Natl Med Assoc. 2009 Jun;101(6):597-603 - PubMed
  16. Hypertension. 1995 Jul;26(1):60-9 - PubMed
  17. Am J Med. 2009 Mar;122(3):290-300 - PubMed
  18. PLoS One. 2007 Mar 14;2(3):e280 - PubMed
  19. Arch Intern Med. 2002 Feb 25;162(4):413-20 - PubMed
  20. Am J Prev Med. 2009 May;36(5):402-409.e5 - PubMed
  21. BMC Health Serv Res. 2015 Jul 03;15:254 - PubMed
  22. Hypertension. 2003 Jun;41(6):1178-9 - PubMed
  23. BMJ Open. 2013 Aug 30;3(8):e003423 - PubMed
  24. Int J Hypertens. 2012;2012:405892 - PubMed
  25. Int J Hypertens. 2016;2016:1656938 - PubMed
  26. Educ Health (Abingdon). 2003 Jul;16(2):230 - PubMed
  27. JAMA. 2003 May 21;289(19):2560-72 - PubMed
  28. Am J Public Health. 2012 Dec;102(12):2242-5 - PubMed
  29. J Am Coll Cardiol. 2002 Sep 4;40(5):937-43 - PubMed
  30. Soc Sci Med. 2005 Jul;61(1):133-55 - PubMed

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