Compliance to hypertension treatment by patients attending primary health care services in Mafeteng District, Lesotho

[摘要] Lesotho is among three countries with the highest incidence of hypertension, whichaccounts for an increased number of deaths and hospital admissions due to noncommunicablediseases. Though treatment compliance is an important component of theeffective management of hypertension, the extent of compliance behaviour of patients inLesotho is not well known.The objectives of this study were to assess compliance behaviour to hypertensiontreatment with regard to medication taking, sodium use and the keeping of appointmentswith healthcare providers, as well as the identification of factors that contribute tocompliance behaviour. The self-determination theory formed the theoretical framework ofthe study. A quantitative descriptive design was applied. Ethical clearance from the Health SciencesResearch Ethics Committee of the University of the Free State and the Health Researchand Ethics Committee of the Ministry of Lesotho were obtained. The three ethicalprinciples that guided the study were respect for people, justice and beneficence.Convenient sampling of the primary healthcare clinics in Lesotho was followed bypurposive sampling of the participants. The sampled clinics were St Andrew's, Ribaneng,Masemouse, Emmaus, Matelile, Malealea, Motsekuoa and Ts'akholo. These clinics areall situated in the rural area of the Mafeteng district. Data was collected from 159participants using the Hill-Bone Compliance to High Blood Pressure Therapyquestionnaire, and data included the pilot and the main results. Demographic data andHill Bone Compliance scale data were analysed by descriptive analysis, frequencies andpercentiles were calculated while open-ended questions were analysed by open codingand thematic analysis. The majority, 62.2% of participants, were women, married (59.1%), and had attained atleast a primary school education. The mean years since the participants had beendiagnosed with hypertension were 9. The overall scores of the Hill-Bone Compliance toHigh Blood Pressure Therapy questionnaire and the three domains (medication taking,sodium use and keeping appointments) indicated good compliance levels by theparticipants. The identified factors that contribute to compliance behaviour include control of blood pressure, maintenance of good health, location of health facilities, and use oftechnology, as well as social support.These findings led to recommendations related to strategies that could improve andmaintain compliance, which highlighted the need for revision of hypertensionmanagement-related pamphlets, the establishment of hypertension support groups andthe improvement of the current health education programmes.

[发布机构] University of the Free State