Medicines availability among hypertensive patients in primary healthcare facilities in a rural province in South Africa : findings and implications

Rampamba, Enos M and Meyer, Johanna C and Helberg, Elvera and Godman, Brian (2021) Medicines availability among hypertensive patients in primary healthcare facilities in a rural province in South Africa : findings and implications. Journal of Research in Pharmacy Practice, 8 (4). pp. 181-185. ISSN 2279-042X (https://doi.org/10.4103/jrpp.JRPP_20_49)

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Abstract

Objective: Controlling blood pressure (BP) in hypertensive patients is a challenge, with the lack of antihypertensive medicines negatively impacting on BP control. Consequently, we assessed the availability of prescribed antihypertensives among patients with chronic hypertension attending primary healthcare (PHC) facilities in a rural province of South Africa and explored any association between medicines availability, the number of prescribed antihypertensive medicines and BP control. Methods: Secondary data that included patients’ demographics, BP and data on medicines availability of the intervention group from a three months operational study conducted in rural PHC facilities in South Africa was analysed. The association between medicines availability, the number of antihypertensive medicines and BP control was determined. Findings: 55 black African patients (89.1% females) with a mean age of 61.3 years were included. Two thirds (67.2%) received all their medicines during their monthly visits, 25.5% received some, and for 7.3% there was no record of whether medicines were dispensed or not. Patients with controlled BP (60.0%) were more likely to have been prescribed only one antihypertensive medicine compared to patients with uncontrolled BP (20.7%) (p=0.017; OR: 5.75; 95% CI: 1.46, 22.61). Conclusion: It is concerning that a third of patients went home without all of their antihypertensive medicines from PHC facilities in South Africa where there is evidence of use of herbal medicines and uncontrolled BP contributing to high morbidity and mortality from cardiovascular diseases. Additional studies are needed to fully explore the association between medicines availability, their use, and BP control among patients.