Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China.

Qiufeng Gao,Lanxi Peng,Wenbin Min,Dirk E Teuwen,Haonan Shi,Aiqin Wang,Hongmei Yi,Jingchun Nie,Yaojiang Shi

doi:10.3390/ijerph17249297

Abstract

Chronic diseases can be controlled through effective self-management. The purpose of this study is to explore the regularity of clinical visits and medication adherence of patients with hypertension or diabetes (PWHD), and its association with the first experience with care and individual factors in rural Southwestern China. This cross-sectional study was carried out in Yunnan province in 2018 and recruited 292 PWHD and 122 village clinics from 122 villages in 10 counties. Participants were interviewed using a structured questionnaire. Results show around 39% of hypertensive and 25% of diabetic patients neither visited physicians nor took medicine regularly during the preceding three months of the interview date. The regression results further indicated that individual characteristics of the PWHD, including patient age, health status, and economic level, as well as their first experience with care, were significantly associated with their regular healthcare behavior. In addition to providing medical services, on average each sample village clinic, with around two physicians, simultaneously managed 180 hypertensive and 45 diabetic patients. This study revealed the need for further reforms in terms of improving self-management and thus recommends an increase in the quantity and the quality of human resources in the primary healthcare realm in rural China.

Highlights

Hypertension and diabetes are high-incidence diseases worldwide, and serious public health problems in China
We investigate the regularity of clinical visits and medication adherence of patients with hypertension or diabetes (PWHD) along with related factors in rural areas of Yunnan province in China
Note: a If the respondent simultaneously had hypertension and diabetes, we calculated the duration of the chronic disease based on the minimum duration. b For the respondents who selected clinical visits, we reported the particular level of facilities they went to. c Some participants went to private clinics or sought treatment with traditional Chinese medicine. d Since 38 hypertensive and 2 diabetic respondents did not seek any treatment, we did not gather information on treatment delay and number of health provider visits from these respondents

Summary

Introduction

Hypertension and diabetes are high-incidence diseases worldwide, and serious public health problems in China. According to a study conducted by Global Burden of Disease (GBD) in 2019, the top five risks for attributable deaths worldwide were both related to hypertension and diabetes, and nearly 20% and 10% of global deaths are caused by hypertension and diabetes, respectively [1]. It is estimated that the prevalence of hypertension and diabetes is around 27% and 10%, respectively, which are among the highest incidences of chronic diseases in China [5,6,7]. As some international comparative studies have suggested, the high incidence of chronic illnesses such as hypertension and diabetes in China is a threat to global efforts to curb healthcare costs [9,10,11]

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