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.