Compliance to hypertension treatment by patients attending primary health care services in Mafeteng District, Lesotho

Abstract

Lesotho is among three countries with the highest incidence of hypertension, which accounts for an increased number of deaths and hospital admissions due to noncommunicable diseases. Though treatment compliance is an important component of the effective management of hypertension, the extent of compliance behaviour of patients in Lesotho is not well known. The objectives of this study were to assess compliance behaviour to hypertension treatment with regard to medication taking, sodium use and the keeping of appointments with healthcare providers, as well as the identification of factors that contribute to compliance behaviour. The self-determination theory formed the theoretical framework of the study. A quantitative descriptive design was applied. Ethical clearance from the Health Sciences Research Ethics Committee of the University of the Free State and the Health Research and Ethics Committee of the Ministry of Lesotho were obtained. The three ethical principles that guided the study were respect for people, justice and beneficence. Convenient sampling of the primary healthcare clinics in Lesotho was followed by purposive sampling of the participants. The sampled clinics were St Andrew’s, Ribaneng, Masemouse, Emmaus, Matelile, Malealea, Motsekuoa and Ts’akholo. These clinics are all situated in the rural area of the Mafeteng district. Data was collected from 159 participants using the Hill-Bone Compliance to High Blood Pressure Therapy questionnaire, and data included the pilot and the main results. Demographic data and Hill Bone Compliance scale data were analysed by descriptive analysis, frequencies and percentiles were calculated while open-ended questions were analysed by open coding and thematic analysis. The majority, 62.2% of participants, were women, married (59.1%), and had attained at least a primary school education. The mean years since the participants had been diagnosed with hypertension were 9. The overall scores of the Hill-Bone Compliance to High Blood Pressure Therapy questionnaire and the three domains (medication taking, sodium use and keeping appointments) indicated good compliance levels by the participants. The identified factors that contribute to compliance behaviour include control of blood pressure, maintenance of good health, location of health facilities, and use of technology, as well as social support. These findings led to recommendations related to strategies that could improve and maintain compliance, which highlighted the need for revision of hypertensionmanagement- related pamphlets, the establishment of hypertension support groups and the improvement of the current health education programmes.