Knowledge, attitudes, beliefs, and blood pressure control in a community-based sample in Ghana.

Department of Medicine, Weill Medical College of Cornell University, New York, NY, USA.
Ethnicity & disease (Impact Factor: 1.12). 02/2005; 15(4):748-52.
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    ABSTRACT: To synthesise the findings from individual qualitative studies on patients' understanding and experiences of hypertension and drug taking; to investigate whether views differ internationally by culture or ethnic group and whether the research could inform interventions to improve adherence. Systematic review and narrative synthesis of qualitative research using the 2006 UK Economic and Social Research Council research methods programme guidance. Medline, Embase, the British Nursing Index, Social Policy and Practice, and PsycInfo from inception to October 2011. Qualitative interviews or focus groups among people with uncomplicated hypertension (studies principally in people with diabetes, established cardiovascular disease, or pregnancy related hypertension were excluded). 59 papers reporting on 53 qualitative studies were included in the synthesis. These studies came from 16 countries (United States, United Kingdom, Brazil, Sweden, Canada, New Zealand, Denmark, Finland, Ghana, Iran, Israel, Netherlands, South Korea, Spain, Tanzania, and Thailand). A large proportion of participants thought hypertension was principally caused by stress and produced symptoms, particularly headache, dizziness, and sweating. Participants widely intentionally reduced or stopped treatment without consulting their doctor. Participants commonly perceived that their blood pressure improved when symptoms abated or when they were not stressed, and that treatment was not needed at these times. Participants disliked treatment and its side effects and feared addiction. These findings were consistent across countries and ethnic groups. Participants also reported various external factors that prevented adherence, including being unable to find time to take the drugs or to see the doctor; having insufficient money to pay for treatment; the cost of appointments and healthy food; a lack of health insurance; and forgetfulness. Non-adherence to hypertension treatment often resulted from patients' understanding of the causes and effects of hypertension; particularly relying on the presence of stress or symptoms to determine if blood pressure was raised. These beliefs were remarkably similar across ethnic and geographical groups; calls for culturally specific education for individual ethnic groups may therefore not be justified. To improve adherence, clinicians and educational interventions must better understand and engage with patients' ideas about causality, experiences of symptoms, and concerns about drug side effects.
    BMJ (online) 01/2012; 345:e3953. · 17.22 Impact Factor
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    ABSTRACT: Chronic non-communicable diseases (NCDs) in Ghana have caused significant illness and death in Ghana for many years. Yet, until recently, they have been neglected and not considered a health priority. This paper reviews the national policy and programme response to chronic NCDs over the period 1992 to 2009. Unpublished reports, documents, relevant files of the Ghana Health Service (GHS) were examined to assess programmatic response to chronic NCDs. Literature was searched to locate published articles on the epidemiology of chronic NCDs in Ghana. The websites of various local and international health institutions were also searched for relevant articles. Several policy and programme initiatives have been pursued with limited success. A national control programme has been established, NCDs are currently a national policy priority, draft tobacco control legislation prepared, public education campaigns on healthy lifestyles, instituted cervical cancer screening and a national health insurance system to reducing medical costs of chronic NCD care. Major challenges include inefficient programme management, low funding, little political interest, low community awareness, high cost of drugs and absence of structured screening programmes. Emerging opportunities include improving political will, government's funding of a national cancer screening programme; basic and operational research; and using funds from well-resourced health programmes for overall health system strengthening. Although Ghana has recently determined to emphasise healthy lifestyles and environment as a major health policy for the prevention and control of chronic NCDs, low funding and weak governance have hindered the effective and speedy implementation of proposed interventions.
    Ghana medical journal 06/2012; 46(2 Suppl):69-78.
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    ABSTRACT: There is a growing prevalence of cardiovascular disease (CVD) risk factors in West Africa and among its migrants to industrialized countries. Despite this, no study has reviewed CVD risk factor prevalence among West Africans in Africa and industrialized countries. To appraise studies on the prevalence of two CVD risk factors (hypertension and overweight/obesity) among two major West African populations (Ghanaians and Nigerians) in Africa and industrialized countries. A comprehensive literature search from 1996 to July 2012 was undertaken to identify quantitative studies on hypertension and overweight/obesity among adult Ghanaians and Nigerians in West Africa and industrialized countries. Twenty studies were included with 10 conducted in Ghana, six conducted in Nigeria and four in industrialized countries. Studies in Ghana and Nigeria reported a hypertension prevalence of 19.3-54.6% with minimal differences between rural, urban, semi-urban, and mixed populations. Of the hypertensive patients, 14-73% were aware of their condition, 3-86% were on treatment, and 2-13% had controlled blood pressures. Overweight/obesity prevalence in Ghana and Nigeria ranged from 20 to 62% and 4 to 49%, respectively. The four studies in industrialized countries reported a hypertension prevalence of 8.4-55% and overweight/obesity prevalence of 65.7-90%. Hypertension and overweight/obesity are highly prevalent conditions in West Africa and in its migrants residing in industrialized countries. Urgent measures are needed to prevent CVD risk factors and halt the clinical sequelae.
    Journal of hypertension 01/2014; · 4.02 Impact Factor

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