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BackgroundMedication adherence plays a crucial role in effectively managing hypertension, a significant public health concern, especially in regions like Central Vietnam. This study aimed to assess medication adherence levels among hypertensive patients in primary care settings and explore the factors influencing adherence within this specific population.MethodsWe conducted a cross-sectional study to evaluate medication adherence and its determinants among individuals with hypertension in Central Vietnam. Medication adherence was assessed using the 5-item version of the Medication Adherence Report Scale self-report. We collected data on the demographics, medical history, lifestyle, hypertension knowledge, along with the patient beliefs and perceptions about hypertension. Logistic regression analysis was employed to identify the key factors associated with their medication adherence.ResultsOur study revealed that only half of the hypertensive patients adhered to their prescribed medication regimens. Several factors significantly influenced their medication adherence, including age, ethnicity, educational level, home blood pressure monitoring, healthy diet, time since hypertension diagnosis, hypertension knowledge, and patient beliefs. According to the logistic regression analysis, a healthy diet and patient beliefs emerged as primary predictors of medication adherence. Patients who strongly believed in the necessity of medication demonstrated better adherence, while concerns about overuse and harm were linked to lower adherence levels.ConclusionsThis study highlighted the suboptimal levels of medication adherence among hypertensive patients in primary care settings in Central Vietnam. It underscored the urgent need for tailored interventions to address this issue. For the sake of better medication adherence, healthcare providers were suggested to prioritize patient education, address patient beliefs and concerns about medication, and promote the practice of home blood pressure monitoring.

[This corrects the article DOI: 10.1371/journal.pone.0242666.].

IntroductionCardiovascular disease (CVD) being the leading cause of the morbidity and mortality in Vietnam, the objective of this study was to estimate the total 10-year CVD risk among adults aged 40-69 years by utilizing World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts in Central Vietnam.Materials and methodsIn this cross-sectional study, multi-staged sampling was used to select 938 participants from a general population aged from 40 to 69. The CVD risk factors were then collected throughout the interviews with a standardized questionnaire, anthropometric measurements and a blood test. The cardiovascular risk was calculated using the WHO/ISH risk prediction charts.ResultsAccording to the WHO/ISH charts, the proportion of moderate risk (10-20%) and high risk (>20%) among the surveyed participants were equal (5.1%). When "blood pressure of more than 160/100 mmHg" was applied, the proportion of moderate risk reduced to 2.3% while the high risk increased markedly to 12.8%. Those proportions were higher in men than in women (at 18.3% and 8.5% respectively, p-value ConclusionsThere was a high burden of CVD risk in Central Vietnam as assessed with the WHO/ISH risk prediction charts, especially in men and among the ethnic minorities. The use of WHO/ISH charts provided a feasible and affordable screening tool in estimating the cardiovascular risk in primary care settings.

Many people who might benefit from specialist palliative care services are not using them.We examined the use of these services and the reasons for not using them in a population in potential need of palliative care.We conducted a population-based survey regarding end-of-life care among physicians certifying a large representative sample (n = 6188) of deaths in Flanders, Belgium.Palliative care services were not used in 79% of cases of people with organ failure, 64% of dementia and 44% of cancer. The most frequently indicated reasons were that 1) existing care already sufficiently addressed palliative and supportive needs (56%), 2) palliative care was not deemed meaningful (26%) and 3) there was insufficient time to initiate palliative care (24%). The reasons differed according to patient characteristics: in people with dementia the consideration of palliative care as not meaningful was more likely to be a reason for not using it; in older people their care needs already being sufficiently addressed was more likely to be a reason. For those patients who were referred the timing of referral varied from a median of six days before death (organ failure) to 16 days (cancer).Specialist palliative care is not initiated in almost half of the people for whom it could be beneficial, most frequently because physicians deem regular caregivers to be sufficiently skilled in addressing palliative care needs. This would imply that the safeguarding of palliative care skills in this regular 'general' care is an essential health policy priority.