Abstract
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.
Highlights
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 blood pressure (BP) reduction
The problem is of particular importance in low- and middle-income countries (LMICs), where about 82% of hypertensive individuals live [3]
Despite the global effort to mitigate the impact of hypertension worldwide, blood pressure (BP) control remains unacceptably low, in LMICs [2, 4]
Summary
Despite the global effort to mitigate the impact of hypertension worldwide, blood pressure (BP) control remains unacceptably low, in LMICs [2, 4]. Treatment and control, the global scenario is worrying. 59% of hypertensive women and 49% of hypertensive men are aware of their hypertension diagnosis; of those, only 47% of women and 38% of men are receiving treatment for hypertension [3]. Of those who are treated, only 23% of women and. 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
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
