treatment status and experiences of hypertension patients at a large health centre in Cape Town
Steyn K, Levitt N, Fourie J, Rossouw K, Martell R, Stander I.
Ethn Dis 1999;9:441-450.
Abstract

Objectives
This study was undertaken at a community health center (CHC) in the Cape Peninsula in order to assess the treatment status, knowledge and experiences of hypertensive patients. In addition, a health indicator sheet for hypertension was evaluated and an attempt was made to identify predictors of blood pressure (BP) control at this clinic.

Methods
Two hundred and two hypertensive patients were selected by interviewing the first available hypertensive patients as interviews were completed. Their BP was measured electronically and by sphygmomanometer and compared to that recorded by the clinician on their clinic folders. Heights and weights were also determined.

Results
Of the hypertensives 41.6% had a BP above 160/95 mmHg and only 42.1% had a BP below 140/90 mmHg. Patients= knowledge of the consequences of hypertension and the actions needed to ensure that complications were prevented were poor; 31% suggested some home remedies for hypertension. The majority of the patients were satisfied with the service they received, but 47% complained about long waiting times, 37% felt that the doctor did not examine them adequately and 15.5% reported that insufficient medication was provided when filling prescriptions. Urine and eye tests were infrequently done in the previous two years. Thirty percent of the patients requested the return of the dedicated BP clubs. Conditional logistic regression models identified that patients, who expressed the need to make proposals to the clinic staff about their care, had better BP control than those who did not.

Conclusions
The BP of hypertensive patients is not optimally controlled at this CHC and both non-drug and drug management of hypertension needs to be improved. Steps to support the hypertensive patients to become more knowledgeable and competent in playing active and more compliant roles in their hypertension care are required. Patients also suggested that dedicated hypertension clubs be reinstituted at the CHCs.

Keywords: Hypertension management - Primary health care - South Africa