Background
Methods
Study design
Study population
Sampling
Data collection and study variables
-
Demographic and social characteristics of patients (sex, age, educational level, religious affiliation, marital status, occupation);
-
Clinical characteristics of patients (duration of HTN, co-morbidity, experience of medication side effects, treatment adherence);
-
Patient-related variables (knowledge of HTN risk factors and complications, knowledge of treatment benefit, perception of hypertension gravity, treatment effectiveness and HTN curability);
-
Healthcare system variables (patient-provider relationship, waiting time, affordability and availability of healthcare); and
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CAM use description (use of CAM, CAM patterns, reasons for CAM use, information source about CAM).
High adherence, if the sum = 0; medium adherence, if the sum is comprised between 1 and 2 and low adherence if the sum is comprised between 3 and 4. | ||
---|---|---|
Have you ever forgotten to take your BP medicine? | 0. No | 1. Yes |
Are you sometimes careless in regard to your medicine? | 0. No | 1. Yes |
Do you skip your medicine when you are feeling well? | 0. No | 1. Yes |
When you feel bad due to the medicine, do you skip it? | 0. No | 1. Yes |
Statistical analysis
Results
Assessment of CAM use
Variable n = 280 |
N (%) |
---|---|
Use of CAM | |
Yes | 73 (26.1) |
No | 207 (73.9) |
Total | 280 (100.0) |
Variables n = 73 |
N (%) |
---|---|
Patterns of CAM | |
Traditional medicine (self-medication/traditional healers) | 31 (42.5) |
Prayer | 26 (35.6) |
Chinese medicine | 13 (17.8) |
Sources of information | |
Friends | 35 (47.9) |
Family members | 26 (35.6) |
Professional area | 9 (12.3) |
Media (radio, TV…) | 8 (11.0) |
Reasons of CAM usage | |
Effectiveness of CAM | 25 (34.2) |
The low cost of CAM | 21 (28.8) |
Holistic care | 19 (26.0) |
Cultural reasons | 11 (15.1) |
CAM has little or no side effects | 9 (12.3) |
Demographic, social and clinical characteristics of participants
Overall n = 280 (% or SD) | CAM users n = 73 (% or SD) | CAM non-users n = 207 (% or SD) |
p
| |
---|---|---|---|---|
Mean age, years (SD) | 60.1 ± 10.6 | 58.7 ± 9.8 | 60.6 ± 10.8 | 0.190 |
Sex | ||||
Female | 192 (68.6) | 50 (68.5) | 142(68.6) | 0.987 |
Male | 88 (31.4) | 23 (31.5) | 65 (31.4) | |
Religion | ||||
Catholic | 121(43.2) | 27 (37.0) | 94 (45.4) | 0.287 |
Pentecostal | 57 (20.4) | 20 (27.4) | 37 (17.9) | |
Protestant | 48 (17.1) | 9 (12.3) | 39 (18.8) | |
Kimbanguist | 22 (7.9) | 7 (9.6) | 15 (7.3) | |
Jehovah’s witnesses | 13 (4.6) | 3 (4.1) | 10 (4.8) | |
Others | 19 (6.8) | 7 (9.6) | 12 (5.8) | |
Marital status | ||||
Married/cohabiting | 147(52.5) | 41 (56.2) | 106(51.2) | 0.466 |
Single/separated/divorced/widowed | 133(47.5) | 32 (43.8) | 101(48.8) | |
Occupation | ||||
No | 137 (48.9) | 41 (56.2) | 96 (46.4) | 0.150 |
Yes | 143 (51.1) | 32 (43.8) | 111 (53.6) | |
Educational level | ||||
Primary | 85 (30.4) | 18 (24.7) | 67 (32.4) | 0.213 |
Secondary | 144 (51.4) | 44 (60.3) | 100 (48.3) | |
Post-secondary | 51 (18.2) | 11 (15.0) | 40 (19.3) |
Overall n = 280 (% or SD) | CAM users n = 73 (% or SD) | CAM non-users n = 207 (% or SD) |
p
| |
---|---|---|---|---|
Duration of HTN | ||||
≥ 5 years | 89 (31.8) | 23 (31.5) | 66 (31.9) | 0,953 |
< 5 years | 191(68.2) | 50 (68.5) | 141(68.1) | |
Co morbidity | ||||
Yes | 158 (56.4) | 37 (50.7) | 121(58.5) | 0,249 |
No | 122 (43.6) | 36 (49.3) | 86 (41.5) | |
Experiencing side effects | ||||
Yes | 110 (39.3) | 44 (60.3) | 66 (31.9) | 0,000a
|
No | 170 (60.7) | 29 (39.7) | 141(68.1) | |
Treatment adherent (n = 265) | ||||
No | 198 (74.7) | 76 (71.7) | 122 (76.7) | 0.356 |
Patients’ knowledge and perception about HTN
Overall n = 280 (% or SD) | CAM users n = 73 (% or SD) | CAM non-users n = 207 (% or SD) |
p
| |
---|---|---|---|---|
Knowledge of HTN risk factors | ||||
Have cited a least three | 16 (5.7) | 3 (4.1) | 13 (6.3) | 0.492 |
Have cited less than three | 264 (94.3) | 70 (95.9) | 194 (93.7) | |
Knowledge of HTN complications | ||||
Have cited a least three | 16 (5.7) | 1 (1.4) | 15 (7.2) | 0.063 |
Have cited less than three | 264 (94.3) | 72 (98.6) | 192 (92.8) | |
Knowledge of treatment benefits | ||||
Have cited less than 3 | 241 (86.1%) | 57 (78.1%) | 184 (88.9%) | 0,022a
|
Have cited a least three | 39 (13.9%) | 16 (21.9%) | 23 (11.1%) | |
Perception of HTN gravity | ||||
HTN is not a serious health condition | 49 (17.5%) | 14 (19.2%) | 35 (16.9%) | 0,673 |
HTN is a serious health condition | 231(82.5%) | 59 (80.8%) | 172 (83.1%) | |
Perception HTN curability | ||||
HTN is curable | 172 (61.4%) | 52 (71.2%) | 120 (58.0%) | 0,045a
|
HTN is not curable | 108 (38.6) | 21 (28.8%) | 87 (42.0%) |
Healthcare system factors
Overall n = 280 (% or SD) | CAM users n = 73 (% or SD) | CAM non-users n = 207 (% or SD) |
p
| |
---|---|---|---|---|
Availability of HCF | ||||
Not available | 34 (12.1) | 7 (9.6) | 27 (13.0) | 0.437 |
Available | 246 (87.9) | 66 (90.4) | 180(87.0) | |
Waiting time | ||||
Very long/long | 150 (53.6) | 48 (65.8) | 102(49.3) | 0.015a
|
Very short/short | 130 (46.4) | 25 (34.2) | 105(50.7) | |
Relationship | ||||
Somewhat good/bad | 11 (3.9) | 3 (4.1) | 8 (3.9) | 0.581 |
Very good/good | 269 (96.1) | 70 (95.9) | 199 (96.1) | |
Affordability | ||||
Not affordable | 98 (35.0) | 26 (35.6) | 72 (34.8) | 0.898 |
Affordable | 182 (65.0) | 47 (64.4) | 135(65.2) | |
Global satisfaction | ||||
No | 37 (13.2) | 11 (15.1) | 26 (12.6) | 0.586 |
Yes | 243 (86.8) | 62 (84.9) | 181(87.4) |
Determinants of CAM use
Factors | CAM use | |||||
---|---|---|---|---|---|---|
Bivariate analysis | Multivariate analysis (LR) | |||||
Crude OR | (95% CI) |
p
| Adjusted OR | (95% CI) |
p
| |
Knowledge of treatment benefits | ||||||
Have cited less than 3 | 2.3 | (1.1–4.8) | 0.022a
| |||
Have cited a least 3 | 1 | - | - | - | - | - |
Perception of HTN curability | ||||||
HTN is curable | 1.8 | (0.97–3.3) | 0.045a
| 2.1 | (1.1–3.7) | 0.019a
|
HTN is incurable | 1 | - | - | - | - | - |
Experiencing side effects | ||||||
Yes | 3.2 | (1.8–5.9) | 0.000a
| 2.9 | (1.7 – 5.1) | 0.000a
|
No | 1 | - | - | - | - | - |
Waiting time | ||||||
Very long/long | 2.0 | (1,1–3.6) | 0,015a
| |||
Very short/short | 1 | - | - | - | - | - |
Patient’s characteristics and perception of HTN curability
Perception of HTN curability | ||||
---|---|---|---|---|
Overall (n = 280) | HTN is curable (n = 172) | HTN is incurable (n = 108) |
p
| |
Mean age, years (SD) | 60.1(10.6) | 60.2(11.0) | 60.0(9.8) | 0.879 |
Sex | ||||
Male | 88 (31.4) | 54 (61.4) | 34 (38.6) | 0.988 |
Female | 192 (68.6) | 118 (61.5) | 74 (38.5) | |
Educational level | ||||
Primary | 85 (30.6) | 54 (63.5) | 31 (36.5) | 0.691 |
Secondary | 142 (51.1) | 85 (59.0) | 59 (41.0) | |
Post-secondary | 51 (18.3) | 33 (64.7) | 18 (35.3) | |
Religious affiliation | ||||
Catholic | 121 (43.2) | 65 (53.7) | 56 (46.3) | 0.006a
|
Pentecostal | 57 (20.4) | 46 (80.7) | 11(19.3) | |
Protestant | 48 (17.1) | 29(60.4) | 19(39.6) | |
Kimbanguist | 22 (7.9) | 16 (72.7) | 6 (27.3) | |
Jehovah’s witnesses | 13(4.6) | 5 (38.5) | 8(61.5) | |
Others | 19 (6.8) | 11 (57.9) | 8(42.1) | |
Duration of HTN | ||||
≥ 5 years | 89 (31.8) | 46 (51.7) | 43 (48.3) | 0.022a
|
< 5 years | 191(68.2) | 126 (66.0) | 65(34.0) |