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. 2023 May 16;13(5):e068238.
doi: 10.1136/bmjopen-2022-068238.

Stakeholder's perspectives on acceptable interventions for promoting hypertension medication adherence in Namibia: nominal group technique

Olivia Nakwafila  1   2 , Benn Sartorius  3   4 , Tonderai Washington Shumba  5 , Tafadzwa Dzinamarira  6 , Tivani Phosa Mashamba-Thompson  3   7
Affiliations

Stakeholder's perspectives on acceptable interventions for promoting hypertension medication adherence in Namibia: nominal group technique

Olivia Nakwafila et al. BMJ Open. .

Abstract

Objective: To determine the most acceptable hypertension intervention package to promote hypertension adherence based on stakeholders' perspectives.

Design: We employed the nominal group technique method and purposively sampled and invited key stakeholders offering hypertension services and patients with hypertension. Phase 1 was focused on determining barriers to hypertension adherence, phase 2 on enablers and phase 3 on the strategies. We employed the ranking method based on a maximum of 60 scores to establish consensus regarding hypertension adherence barriers, enablers and proposed strategies.

Setting and participants: 12 key stakeholders were identified and invited to participate in the workshop in Khomas region. Key stakeholders included subject matter experts in non-communicable diseases, family medicine and representatives of our target population (hypertensive patients).

Results: The stakeholders reported 14 factors as barriers and enablers to hypertension adherence. The most important barriers were: lack of knowledge on hypertension (57 scores), unavailability of drugs (55 scores) and lack of social support (49 scores). Patient education emerged as the most important enabler (57 scores), availability of drugs emerged second (53 scores) and third having a support system (47 scores). Strategies were 17 and ranked as follows: continuous patient education as the most desirable (54 scores) strategy to help promote hypertension adherence, followed by developing a national dashboard to primarily monitor stock (52 scores) and community support groups for peer counselling (49 scores).

Conclusions: Multifaceted educational intervention package targeting patient and healthcare system factors may be considered in implementing Namibia's most acceptable hypertension package. These findings will offer an opportunity to promote adherence to hypertension therapy and reduce cardiovascular outcomes. We recommend a follow-up study to evaluate the proposed adherence package's feasibility.

Keywords: Hypertension; PUBLIC HEALTH; QUALITATIVE RESEARCH.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Barriers to hypertension adherence.
Figure 2
Figure 2
Enablers to hypertension adherence.
See this image and copyright information in PMC

References

    1. WHO . Hypertension: Key facts. 2021. Available: https://www.who.int/news-room/fact-sheets/detail/hypertension [Accessed 26 Jun 2022].
    1. Mills KT, Bundy JD, Kelly TN, et al. . Global disparities of hypertension prevalence and control: A systematic analysis of population-based studies from 90 countries. Circulation 2016;134:441–50. 10.1161/CIRCULATIONAHA.115.018912 - DOI - PMC - PubMed
    1. WHO . World health Rankings live longer live better. 2020. Available: https://www.worldlifeexpectancy.com/namibia-hypertension [Accessed 26 Jun 2022].
    1. Burnier M, Egan BM. Adherence in hypertension. Circ Res 2019;124:1124–40. 10.1161/CIRCRESAHA.118.313220 - DOI - PubMed
    1. Kostova D, Spencer G, Moran AE, et al. . The cost-effectiveness of hypertension management in low-income and middle-income countries: A review. BMJ Glob Health 2020;5:e002213. 10.1136/bmjgh-2019-002213 - DOI - PMC - PubMed