Abstract
Objective There is poor adherence to antihypertensive therapies among women in India. To determine its socioeconomic barriers we performed a qualitative study on Indian rural women with hypertension. Methods In-depth interviews with women having hypertension and presenting to outpatient department at a teaching hospital were performed in 30 women aged 35-65 years, using a questionnaire focused on reasons for nonadherence and poor lifestyle modification. Low to medium adherence was observed in two-thirds of women. Results Majority of women were from low socioeconomic status and were illiterate. Awareness of hypertension and its complications was poor. Knowledge and practices of cessation of smoking and tobacco use and salt restriction in hypertension were low. Efforts to increase physical activity and decrease dietary fat and sugar intake were largely absent. Local follow-up at rural community health centres was not practiced due to physician nonavailability and about half used alternative systems of medicine. None had health insurance or access to free medicines. All the women had to pay out-of-pocket for medicines and were concerned with cost of therapy as well as pill burden. Half of the women borrowed money from relatives or friends to reach the hospital and pay for medicines. Conclusions Socioeconomic barriers for low adherence to antihypertensive medication in women in India are low awareness of hypertension and complications, poor access to care, out-of-pocket payments, borrowing money, lack of insurance, and cost of medicines.
Highlights
Hypertension is a widely prevalent disorder and affects more than a billion individuals worldwide [1]
Majority of women were from low socioeconomic status households, illiterate, and housewives
The present study shows that the problems of access and costs are high in rural areas of the country
Summary
Hypertension is a widely prevalent disorder and affects more than a billion individuals worldwide [1]. Recent studies have reported that hypertension is present in 25-30% urban and 10-15% rural subjects in India [4,5,6]. This extrapolates to more than 200 million patients with hypertension in the country [6]. Studies from Indian report that uncontrolled or poorly controlled hypertension is widely prevalent [3]. In developed countries it has been reported that 30-40% patients with hypertension are not controlled to target while this proportion in low and lower-middle income developing countries is 60-70% in urban and 80-90% in rural populations [7]. It has been reported that properly controlled BP in patients with hypertension can reduce cardiovascular mortality by as much as 30% [8]
Sign-in/Register to view highlights & summary 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.
