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Patients’ and healthcare providers’ perceptions and practices regarding hypertension, pharmacy-based care, and mHealth in Lagos, Nigeria: a mixed methods study
BACKGROUND: In sub-Saharan Africa, cardiovascular disease is becoming a leading cause of death, with high blood pressure as number one risk factor. In Nigeria, access and adherence to hypertension care are poor. A pharmacy-based hypertension care model with remote monitoring by cardiologists through...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365248/ https://www.ncbi.nlm.nih.gov/pubmed/30645210 http://dx.doi.org/10.1097/HJH.0000000000001877 |
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author | Cremers, Anne L. Alege, Abiola Nelissen, Heleen E. Okwor, Tochi J. Osibogun, Akin Gerrets, René Van’t Hoog, Anja H. |
author_facet | Cremers, Anne L. Alege, Abiola Nelissen, Heleen E. Okwor, Tochi J. Osibogun, Akin Gerrets, René Van’t Hoog, Anja H. |
author_sort | Cremers, Anne L. |
collection | PubMed |
description | BACKGROUND: In sub-Saharan Africa, cardiovascular disease is becoming a leading cause of death, with high blood pressure as number one risk factor. In Nigeria, access and adherence to hypertension care are poor. A pharmacy-based hypertension care model with remote monitoring by cardiologists through mHealth was piloted in Lagos to increase accessibility to quality care for hypertensive patients. OBJECTIVES: To describe patients’ and healthcare providers’ perceptions and practices regarding hypertension, pharmacy-based care, and mHealth and explore how this information may improve innovative hypertension service delivery. METHODS: This study consisted of observations of patient–pharmacy staff interactions and hypertension care provided, four focus group discussions and in-depth interviews with 30 hypertensive patients, nine community pharmacists, and six cardiologists, and structured interviews with 328 patients. RESULTS: Most patients were knowledgeable about biomedical causes and treatment of hypertension, but often ignorant about the silent character of hypertension. Reasons mentioned for not adhering to treatment were side effects, financial constraints, lack of health insurance, and cultural or religious reasons. Pharmacists additionally mentioned competition with informal, cheaper healthcare providers. Patients highly favored pharmacy-based care, because of the pharmacist–patient relationship, accessibility, small-scale, and a pharmacy's registration at an association. The majority of respondents were positive towards mHealth. CONCLUSION: Facilitating factors for innovative pharmacy-based hypertension care were: patients’ biomedical perceptions, pharmacies’ strong position in the community, and respondents’ positive attitude towards mHealth. We recommend health education and strengthening pharmacists’ role to address barriers, such as misperceptions that hypertension always is symptomatic, treatment nonadherence, and unfamiliarity with mHealth. Future collaboration with insurance providers or other financing mechanisms may help diminish patients’ financial barriers to appropriate hypertension treatment. |
format | Online Article Text |
id | pubmed-6365248 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-63652482019-02-20 Patients’ and healthcare providers’ perceptions and practices regarding hypertension, pharmacy-based care, and mHealth in Lagos, Nigeria: a mixed methods study Cremers, Anne L. Alege, Abiola Nelissen, Heleen E. Okwor, Tochi J. Osibogun, Akin Gerrets, René Van’t Hoog, Anja H. J Hypertens ORIGINAL PAPERS: Therapeutic aspects BACKGROUND: In sub-Saharan Africa, cardiovascular disease is becoming a leading cause of death, with high blood pressure as number one risk factor. In Nigeria, access and adherence to hypertension care are poor. A pharmacy-based hypertension care model with remote monitoring by cardiologists through mHealth was piloted in Lagos to increase accessibility to quality care for hypertensive patients. OBJECTIVES: To describe patients’ and healthcare providers’ perceptions and practices regarding hypertension, pharmacy-based care, and mHealth and explore how this information may improve innovative hypertension service delivery. METHODS: This study consisted of observations of patient–pharmacy staff interactions and hypertension care provided, four focus group discussions and in-depth interviews with 30 hypertensive patients, nine community pharmacists, and six cardiologists, and structured interviews with 328 patients. RESULTS: Most patients were knowledgeable about biomedical causes and treatment of hypertension, but often ignorant about the silent character of hypertension. Reasons mentioned for not adhering to treatment were side effects, financial constraints, lack of health insurance, and cultural or religious reasons. Pharmacists additionally mentioned competition with informal, cheaper healthcare providers. Patients highly favored pharmacy-based care, because of the pharmacist–patient relationship, accessibility, small-scale, and a pharmacy's registration at an association. The majority of respondents were positive towards mHealth. CONCLUSION: Facilitating factors for innovative pharmacy-based hypertension care were: patients’ biomedical perceptions, pharmacies’ strong position in the community, and respondents’ positive attitude towards mHealth. We recommend health education and strengthening pharmacists’ role to address barriers, such as misperceptions that hypertension always is symptomatic, treatment nonadherence, and unfamiliarity with mHealth. Future collaboration with insurance providers or other financing mechanisms may help diminish patients’ financial barriers to appropriate hypertension treatment. Lippincott Williams & Wilkins 2019-02 2018-08-16 /pmc/articles/PMC6365248/ /pubmed/30645210 http://dx.doi.org/10.1097/HJH.0000000000001877 Text en Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | ORIGINAL PAPERS: Therapeutic aspects Cremers, Anne L. Alege, Abiola Nelissen, Heleen E. Okwor, Tochi J. Osibogun, Akin Gerrets, René Van’t Hoog, Anja H. Patients’ and healthcare providers’ perceptions and practices regarding hypertension, pharmacy-based care, and mHealth in Lagos, Nigeria: a mixed methods study |
title | Patients’ and healthcare providers’ perceptions and practices regarding hypertension, pharmacy-based care, and mHealth in Lagos, Nigeria: a mixed methods study |
title_full | Patients’ and healthcare providers’ perceptions and practices regarding hypertension, pharmacy-based care, and mHealth in Lagos, Nigeria: a mixed methods study |
title_fullStr | Patients’ and healthcare providers’ perceptions and practices regarding hypertension, pharmacy-based care, and mHealth in Lagos, Nigeria: a mixed methods study |
title_full_unstemmed | Patients’ and healthcare providers’ perceptions and practices regarding hypertension, pharmacy-based care, and mHealth in Lagos, Nigeria: a mixed methods study |
title_short | Patients’ and healthcare providers’ perceptions and practices regarding hypertension, pharmacy-based care, and mHealth in Lagos, Nigeria: a mixed methods study |
title_sort | patients’ and healthcare providers’ perceptions and practices regarding hypertension, pharmacy-based care, and mhealth in lagos, nigeria: a mixed methods study |
topic | ORIGINAL PAPERS: Therapeutic aspects |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365248/ https://www.ncbi.nlm.nih.gov/pubmed/30645210 http://dx.doi.org/10.1097/HJH.0000000000001877 |
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