Table 1
Baseline characteristics of participants in the medication adherence clubs.
| CHARACTERISTICS | RURAL SITE (N = 22) | URBAN SITE (N = 82) | OVERALL (N = 104) |
|---|---|---|---|
| Demographics | |||
| Age, years – mean (SD) | 65.6 (9.3) | 54.4 (9.8) | 56.8 (10.7) |
| Female – n (%) | 15 (68.2) | 57 (69.5) | 72 (69.2) |
| Marital status – n (%) | |||
| Married | 18 (81.8) | 72 (87.8) | 90 (86.5) |
| Widowed | 4 (18.2) | 10 (12.2) | 14 (13.5) |
| Level of Education – n (%) | |||
| None | 2 (9.1) | 2 (2.4) | 4 (3.9) |
| Primary school | 9 (40.9) | 29 (35.4) | 38 (36.5) |
| Secondary school | 9 (40.9) | 35 (42.7) | 44 (42.3) |
| Post-secondary or tertiary education | 2 (9.1) | 16 (19.5) | 18 (17.3) |
| Employment Status – n (%) | |||
| Currently employed | 4 (18.2) | 40 (48.8) | 44 (42.3) |
| Unemployed | 13 (59.1) | 19 (23.2) | 32 (30.8) |
| Retired | 1 (4.5) | 4 (4.8) | 5 (4.8) |
| Never worked | 4 (18.2) | 19 (23.2) | 23 (22.1) |
| Comorbidities and other risk factors | |||
| Prior myocardial infarction– n (%) | 0 | 0 | 0 |
| Prior stroke– n (%) | 0 | 0 | 0 |
| Prior diagnosis of peripheral artery disease– n (%) | 0 | 1 (1.2) | 1 (0.9) |
| Prior diagnosis of heart failure– n (%) | 0 | 0 | 0 |
| Diabetes – n (%) | 1 (4.5) | 9 (11.0) | 10 (9.6) |
| Chronic kidney disease – n (%) | 0 | 1 (1.2) | 1 (0.9) |
| Smoking – n (%) | |||
| Current smoker | 0 | 0 | 0 |
| Ex-smoker | 1 (4.5) | 1 (1.2) | 2 (1.9) |
| Clinical data | |||
| BMI, kg/m2 – mean (SD) | 29.4 (9.2) | 27.8 (5.1) | 28.2 (6.2) |
| Systolic BP, mmHg – mean (SD) | 141.5 (18.4) | 148.1 (20.4) | 146.7 (20.1) |
| Diastolic BP, mmHg – mean (SD) | 86.0 (9.8) | 87.2 (11.5) | 86.9 (11.2) |
| Heart rate, bpm – mean (SD) | 73.1 (8.7) | 80.0 (12.0) | 78.5 (11.6) |
| BP lowering therapy | |||
| Number of classes – mean (SD) | 2.14 (0.56) | 1.67 (0.63) | 1.77 (0.64) |
| 1 drug prescribed – n (%) | 2 (9.1%) | 33 (40.2%) | 35 (33.7%) |
| 2 drugs prescribed – n (%) | 15 (68.2%) | 44 (53.7%) | 59 (56.7%) |
| ≥ 3 drugs prescribed – n (%) | 5 (22.7%) | 5 (6.1%) | 10 (9.6%) |
| Blood pressure lowering classes | |||
| Thiazide diuretic | 5 (22.7%) | 46 (56.1%) | 51 (49.0%) |
| Thiazide diuretic + potassium sparing diuretic | 11 (50.0%) | 9 (11.0%) | 20 (19.2%) |
| ACE inhibitor or ARB | 0 | 25 (30.5%) | 25 (24.0%) |
| Calcium channel blockers | 14 (63.6%) | 50 (61.0%) | 64 (61.5%) |
| Medication adherence | |||
| Visual Analogue scale, % of medication taken – mean (SD) | 42.4 (12.8) | 41.4 (11.6) | 41.4 (11.9) |
[i] ACE, Angiotensin conversing enzyme; ARB, Angiotensin II receptor blocker; BMI, body mass index; BP, blood pressure; SD, standard deviation.
Table 2
Changes in medication adherence and blood pressure over time.
| BASELINE | 6-MONTHS FOLLOW-UP ASSESSMENT | MEAN DIFFERENCE | P VALUE | |
|---|---|---|---|---|
| Facility follow-up visits (n = 25) | ||||
| Primary outcome | ||||
| Visual Analogue scale, % of medication taken – mean (SD) | 41.4 (11.9) | 66.54 (21.0) | 25.0 (22.1) | <0.0001 |
| Key secondary outcome | ||||
| Systolic BP, mmHg – mean (SD) | 146.7 (20.1) | 130.96 (16.9) | 9.4 (17.9) | 0.0149 |
| Diastolic BP, mmHg – mean (SD) | 86.9 (11.2) | 81.9 (10.0) | 1.6 (10.3) | 0.4353 |
| All follow-ups (facility follow-up visits + home visits) (n = 65) | ||||
| Primary outcome | ||||
| Visual Analogue scale, % of medication taken – mean (SD) | 41.4 (11.9) | 57.3 (25.3) | 15.5 (28.3) | <0.0001 |
| Key secondary outcome | ||||
| Systolic BP, mmHg – mean (SD) | 146.7 (20.1) | 132.3 (22.0) | 13.0 (20.9) | <0.0001 |
| Diastolic BP, mmHg – mean (SD) | 86.9 (11.2) | 82.9 (12.2) | 3. 6 (12.1) | 0.0202 |
Figure 1
Flowchart of number of patients invited, attending each adherence club meeting, and attending facility follow-up or home visit.
Table 3
Focus group discussion participants characteristics.
| STUDY SITE LOCATION | STUDY PARTICIPANTS AT FIRST DISCUSSION | INTERVIEW METHOD | STUDY PARTICIPANTS AT SECOND DISCUSSION | INTERVIEW METHOD |
|---|---|---|---|---|
| Urban site | 17 participants (8 women and 9 men) | FGD1 | 22 participants (12 women and 10 men) | FGD3 |
| Rural site | 21 participants (11 women and 10 men) | FGD2 | 4 participants (3 women and 1 man) | FGD4 |
| Total | 38 (19 women and 19 men) | 26 (15 women and 11 men) |
[i] FDG, focus group discussion.