1. Factors associated with poor adherence to medication among hypertensive patients in twelve low and middle income Sub-Saharan countries
- Author
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Macquart de Terline, Diane, Kane, Adama, Kramoh, Kouadio Euloge, Ali Toure, Ibrahim, Mipinda, Jean Bruno, Diop, Ibrahima Bara, Nhavoto, Carol, Balde, Dadhi M., Ferreira, Beatriz, Dèdonougbo Houenassi, Martin, Ikama, Méo Stéphane, Kingue, Samuel, Kouam Kouam, Charles, Takombe, Jean Laurent, Limbole, Emmanuel, Mfeukeu Kuate, Liliane, N’guetta, Roland, Damorou, Jean Marc, Sesso, Zouwera, Sidy Ali, Abdallahi, Perier, Marie-Cécile, Azizi, Michel, Empana, Jean Philippe, Jouven, Xavier, Antignac, Marie, Service de Pharmacie [CHU Saint Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centre de Ressources Biologiques HUEP-UPMC (CRB HUEP-UPMC), UMS omique (OMIQUE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Aristide-Le-Dantec, Institute of Cardiology of Abidjan [Abidjan, Côte d’Ivoire], Internal Medicine and Cardiology Department [Niamey, Niger], University Hospital of Lamorde [Niamey, Niger], University hospital of Libreville [Libreville, Gabon], Cardiology Department [Dakar, Senegal], University Hospital of Fann [Dakar, Senegal], Instituto do Coração [Maputo, Mozambique] (ICOR), Department of Cardiology [Conakry, Guinea], University Hospital of Conakry [Conakry, Guinea], National University hospital of Hubert K. MAGA [Cotonou, Bénin] (CNHU-HKM), University Marien Ngouabi of Brazzaville (umng), Université de Yaoundé I, Internal Medicine Department [Bafoussam, Cameroon], Régional Hospital [Bafoussam, Cameroon], General Hospital of Kinshasa [Kinshasa, Democratic Republic of the Congo], Department of Internal Medicine of la Gombe [Kinshasa, Democratic Republic of the Congo] (CMCG), Ngaliema Hospital [Kinshasa, Democratic Republic of the Congo], Hôpital Central de Yaoundé [Yaoundé], Cardiology department [Lomé, Togo], CHU de Lomé [Togo], Cardiology clinics [Nouakchott, Mauritania], Service de médecine vasculaire et hypertension artérielle [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Gestionnaire, Hal Sorbonne Université, CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
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Questionnaires ,Male ,Physiology ,Blood Pressure ,Vascular Medicine ,Biochemistry ,Ion Channels ,Surveys and Questionnaires ,Medicine and Health Sciences ,Prevalence ,Aged, 80 and over ,Pharmaceutics ,Physics ,Drugs ,Middle Aged ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Electrophysiology ,Antihypertensive Drugs ,Research Design ,[SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology ,Hypertension ,Physical Sciences ,Income ,Medicine ,Calcium Antagonist Therapy ,Female ,Research Article ,Adult ,Science ,Biophysics ,Cardiology ,Neurophysiology ,Research and Analysis Methods ,Medication Adherence ,Complementary and Alternative Medicine ,Drug Therapy ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Humans ,Developing Countries ,Poverty ,Africa South of the Sahara ,Antihypertensive Agents ,Aged ,Pharmacology ,Survey Research ,Biology and Life Sciences ,Proteins ,Traditional Medicine ,Cross-Sectional Studies ,Socioeconomic Factors ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Calcium Channels ,Receptor Antagonist Therapy ,Neuroscience ,Antihypertensives - Abstract
IntroductionOver the past few decades, the prevalence of hypertension has dramatically increased in Sub-Saharan Africa. Poor adherence has been identified as a major cause of failure to control hypertension. Scarce data are available in Africa.AimsWe assessed adherence to medication and identified socioeconomics, clinical and treatment factors associated with low adherence among hypertensive patients in 12 sub-Saharan African countries.MethodWe conducted a cross-sectional survey in urban clinics of both low and middle income countries. Data were collected by physicians on demographics, treatment and clinical data among hypertensive patients attending the clinics. Adherence was assessed by questionnaires completed by the patients. Factors associated with low adherence were investigated using logistic regression with a random effect on countries.ResultsThere were 2198 individuals from 12 countries enrolled in the study. Overall, 678 (30.8%), 738 (33.6%), 782 (35.6%) participants had respectively low, medium and high adherence to antihypertensive medication. Multivariate analysis showed that the use of traditional medicine (OR: 2.28, 95%CI [1.79-2.90]) and individual wealth index (low vs. high wealth: OR: 1.86, 95%CI [1.35-2.56] and middle vs. high wealth: OR: 1.42, 95%CI [1.11-1.81]) were significantly and independently associated with poor adherence to medication. In stratified analysis, these differences in adherence to medication according to individual wealth index were observed in low-income countries (pConclusionThis study revealed the high frequency of poor adherence in African patients and the associated factors. These findings should be useful for tailoring future programs to tackle hypertension in low income countries that are better adapted to patients, with a potential associated enhancement of their effectiveness.
- Published
- 2019
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