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Sambou ML, Bafei SEC, Bass P. Factors associated with knowledge of hypertension risk factors and symptoms among Gambian women: A cross-sectional study based on the Gambia Demographic and Health Survey. Prev Med Rep 2024; 42:102754. [PMID: 38764757 PMCID: PMC11101705 DOI: 10.1016/j.pmedr.2024.102754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/04/2024] [Accepted: 05/06/2024] [Indexed: 05/21/2024] Open
Abstract
Background We examined the factors associated with knowledge of hypertension risk factors and symptoms among Gambian women. Methods This cross-section study was based on 11, 865 female participants (aged 15-49 years) of The Gambia Demographic and Health Survey 2019-2020. We performed descriptive statistics, and multivariate-adjusted logistic regression models. Results Only 34.89 % and 36.82 % of the participants knew at least one risk factor and symptom of hypertension, respectively. Women who had never measured their blood pressure had a reduced odds of knowing a hypertension risk factor (OR = 0.68; 95 %CI: 0.60---0.77; P < 0.01) and symptom (OR = 0.56; 95 %CI: 0.49---0.64; P < 0.01). Compared to women with higher education, those with no education had a lower odds of knowing a hypertension risk factor (OR = 0.18; 95 %CI: 0.12---0.27; P < 0.01) and symptom (OR = 0.32; 95 %CI: 0.23---0.45; P < 0.01). Similarly, women who never used the internet had reduced odds of mentioning a hypertension risk factor (OR = 0.55; 95 %CI: 0.48---0.61; P < 0.01) and symptom (OR = 0.61; 95 %CI: 0.54---0.69; P < 0.01). Those who never watched television had decreased odds of knowing a hypertension risk factor (OR = 0.74; 95 %CI: 0.63--0.86; P < 0.01) and symptoms (OR = 0.68; 95 %CI: 0.58---0.80; P < 0.01). Conclusion: Fewer women could mention at least one hypertension risk factor and symptom. We also found that knowledge of hypertension risk factors and symptoms was associated with education level and socio-economic status.
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Affiliation(s)
- Muhammed Lamin Sambou
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, The University of the Gambia, Brikama Campus, Gambia
| | | | - Paul Bass
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, The University of the Gambia, Brikama Campus, Gambia
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Niko MM, Karbasi Z, Kazemi M, Zahmatkeshan M. Comparing ChatGPT and Bing, in response to the Home Blood Pressure Monitoring (HBPM) knowledge checklist. Hypertens Res 2024; 47:1401-1409. [PMID: 38438722 DOI: 10.1038/s41440-024-01624-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 03/06/2024]
Abstract
High blood pressure is one of the major public health problems that is prevalent worldwide. Due to the rapid increase in the number of users of artificial intelligence tools such as ChatGPT and Bing, it is expected that patients will use these tools as a source of information to obtain information about high blood pressure. The purpose of this study is to check the accuracy, completeness, and reproducibility of answers provided by ChatGPT and Bing to the knowledge questionnaire of blood pressure control at home. In this study, ChatGPT and Bing's responses to the HBPM 10-question knowledge checklist on blood pressure measurement were independently reviewed by three cardiologists. The mean accuracy rating of ChatGPT was 5.96 (SD = 0.17) indicating the responses were highly accurate overall, with the vast majority receiving the top score. The mean accuracy and completeness of ChatGPT were 5.96 (SD = 0.17) and 2.93 (SD = 0.25) and in Bing were 5.31 (SD = 0.67), and 2.13 (SD = 0.53) Respectively. Due to the expansion of artificial intelligence applications, patients can use new tools such as ChatGPT and Bing to search for information and at the same time can trust the information obtained. we found that the answers obtained from ChatGPT are reliable and valuable for patients, while Bing is also considered a powerful tool, it has more limitations than ChatGPT, and the answers should be interpreted with caution.
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Affiliation(s)
| | - Zahra Karbasi
- Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Kazemi
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Maryam Zahmatkeshan
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
- School of Allied Medical Sciences, Fasa University of Medical Sciences, Fasa, Iran.
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Khoiry QA, Alfian SD, van Boven JFM, Abdulah R. Self-reported medication adherence instruments and their applicability in low-middle income countries: a scoping review. Front Public Health 2023; 11:1104510. [PMID: 37521968 PMCID: PMC10374330 DOI: 10.3389/fpubh.2023.1104510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/23/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Medication non-adherence is an important public health issue, associated with poor clinical and economic outcomes. Globally, self-reported instruments are the most widely used method to assess medication adherence. However, the majority of these were developed in high-income countries (HICs) with a well-established health care system. Their applicability in low- and middle-income countries (LMICs) remains unclear. The objective of this study is to systematically review the applicability of content and use of self-reported adherence instruments in LMICs. Method A scoping review informed by a literature search in Pubmed, EBSCO, and Cochrane databases was conducted to identify studies assessing medication adherence using self-reported instruments for patients with five common chronic diseases [hypertension, diabetes, dyslipidemia, asthma, or Chronic Obstructive Pulmonary Disease (COPD)] in LMICs up to January 2022 with no constraints on publication year. Two reviewers performed the study selection process, data extraction and outcomes assessment independently. Outcomes focused on LMIC applicability of the self-reported adherence instruments assessed by (i) containing LMIC relevant adherence content; (ii) methodological quality and (iii) fees for use. Findings We identified 181 studies that used self-reported instruments for assessing medication adherence in LMICs. A total of 32 distinct types of self-reported instruments to assess medication adherence were identified. Of these, 14 self-reported instruments were developed in LMICs, while the remaining ones were adapted from self-reported instruments originally developed in HICs. All self-reported adherence instruments in studies included presented diverse potential challenges regarding their applicability in LMICs, included an underrepresentation of LMIC relevant non-adherence reasons, such as financial issues, use of traditional medicines, religious beliefs, lack of communication with healthcare provider, running out of medicine, and access to care. Almost half of included studies showed that the existing self-reported adherence instruments lack sufficient evidence regarding cross cultural validation and internal consistency. In 70% of the studies, fees applied for using the self-reported instruments in LMICs. Conclusion There seems insufficient emphasis on applicability and methodological rigor of self-reported medication adherence instruments used in LMICs. This presents an opportunity for developing a self-reported adherence instrument that is suitable to health systems and resources in LMICs. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42022302215.
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Affiliation(s)
- Qisty A. Khoiry
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Sofa D. Alfian
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Job F. M. van Boven
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
- Medication Adherence Expertise Centre of The Northern Netherlands (MAECON), Groningen, Netherlands
| | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
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Zhou C, Chen J, Tan F, Lai S, Li X, Pu K, Wu J, Dong Y, Zhao F. Relationship between self-care compliance, trust, and satisfaction among hypertensive patients in China. Front Public Health 2023; 10:1085047. [PMID: 36743158 PMCID: PMC9889937 DOI: 10.3389/fpubh.2022.1085047] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction Hypertension is a growing public health concern worldwide. It is a leading risk factor for all-cause mortality and may lead to complications such as cardiovascular disease, stroke, and kidney failure. Poor compliance of hypertensive patients is one of the major barriers to controlling high blood pressure. Compliance is not ideal among Chinese patients, and increasing patient self-care compliance with hypertension is necessary. Methods This article analyzes the status of self-care compliance, trust, and satisfaction among Chinese hypertensive patients using cross-sectional data from Zhejiang Province. We use a multi-group structural equation model (MGSEM) to compare the interrelationships across genders. Results The study's findings show that the average trust, satisfaction, and compliance scores are 3.92 ± 0.55, 3.98 ± 0.61, and 3.33 ± 0.41, respectively. Female patients exhibit higher average total scores for trust and compliance than male patients. The SEM results indicate that trust has a direct positive association with compliance [β = 0.242, 95% CI: (0.068, 0.402)] and satisfaction [β = 0.260, 95% CI: (0.145, 0.367)], while their satisfaction is not directly associated with compliance. The results of MGSEM show that trust has an indirect effect on compliance in the male group through satisfaction [β = 0.051, P < 0.05, 95% CI: (0.012, 0.116)]. In the female group, trust has a direct effect on satisfaction [β = 0.235, P < 0.05, 95% CI: (0.041, 0.406)] and compliance [β = 0.319, P < 0.01, 95% CI: (0.086, 0.574)]. Discussion This study reveals the mechanisms of self-care compliance, trust, and satisfaction among Chinese hypertensive patients. Its findings may serve as a reference for guiding primary healthcare providers to improve hypertension patients' compliance and implement gender-targeted health interventions.
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Affiliation(s)
- Chi Zhou
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China,*Correspondence: Chi Zhou ✉
| | - Jingchun Chen
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Fang Tan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sihong Lai
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xu Li
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Ke Pu
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Jiahui Wu
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Yin Dong
- Department of Hospital Office, The People's Hospital of Yuhuan, Taizhou, China,Yin Dong ✉
| | - Falin Zhao
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China,Falin Zhao ✉
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Horvat O, Halgato T, Stojšić-Milosavljević A, Paut Kusturica M, Kovačević Z, Bukumiric D, Tomas A. Identification of patient-related, healthcare-related and knowledge-related factors associated with inadequate blood pressure control in outpatients: a cross-sectional study in Serbia. BMJ Open 2022; 12:e064306. [PMID: 36323484 PMCID: PMC9639095 DOI: 10.1136/bmjopen-2022-064306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To determine rate of blood pressure (BP) control and to analyse patient-related, medication-related and healthcare system-related factors associated with poor BP control in outpatients with hypertension (HT). DESIGN Cross-sectional study. SETTING Two study sites with different levels of healthcare (primary healthcare (PHC) and secondary level of healthcare (SHC)) in Vojvodina, Northern Serbia. PARTICIPANTS A total of 581 patients (response rate 96.8%) visiting their primary care physician between July 2019 and June 2020 filled out a pretested semistructured questionnaire and had a BP reading during their regular appointments. PRIMARY AND SECONDARY OUTCOME MEASURES Data on demographics, medication, BP control (target systolic BP≤140 mm Hg and∕ or diastolic BP≤90 mm Hg) and knowledge on HT was collected. Based on the median of knowledge score, patients were classified as having poor, average and adequate knowledge. RESULTS Majority of the respondents (74.9%) had poorly controlled BP and had HT longer than 10 years. Larger number of patients at PHC site was managed with monotherapy while at the SHC majority received three or more antihypertensive drugs. Respondents from SHC showed a significantly lower knowledge score (9, 2-15) compared with the respondents from PHC (11, 4-15, p=0.001). The share of respondents with adequate knowledge on HT was significantly higher in the group with good BP control (26% and 9.2%, respectively). In a multivariate regression analysis, factors associated with poor BP control were knowledge (B=-1.091; p<0001), number of drugs (B=0536; p<0001) and complications (B=0898; p=0004). CONCLUSIONS Poor BP control is common in outpatients in Serbia, irrespective of the availability of different levels of healthcare. Patients with poor knowledge on HT, with complications of HT and those with multiple antihypertensive drugs, were at particular risk of poor BP control. Our study could serve as a basis for targeted interventions to improve HT management.
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Affiliation(s)
- Olga Horvat
- Department of Pharmacology and Toxicology, Faculty of Medicine Novi Sad, University of Novi Sad, Novi Sad, Serbia
| | - Tinde Halgato
- Health Center "Dr Janoš Hadži" Bačka Topola, Novi Sad, Serbia
| | - Anastazija Stojšić-Milosavljević
- Department of Pharmacology and Toxicology, Faculty of Medicine Novi Sad, University of Novi Sad, Novi Sad, Serbia
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - Milica Paut Kusturica
- Department of Pharmacology and Toxicology, Faculty of Medicine Novi Sad, University of Novi Sad, Novi Sad, Serbia
| | - Zorana Kovačević
- Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, Novi Sad, Serbia
| | - Dragica Bukumiric
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - Ana Tomas
- Department of Pharmacology and Toxicology, Faculty of Medicine Novi Sad, University of Novi Sad, Novi Sad, Serbia
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Fentaw Z, Adamu K. Hypertensive patients compliance for clinician counseling in dessie city, Ethiopia. Heliyon 2022; 8:e11645. [DOI: 10.1016/j.heliyon.2022.e11645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/02/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
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Chen L, Liu Y, Xi X. Study of knowledge, attitude and practice regarding patient education in hypertension among community pharmacists in China. BMC Health Serv Res 2022; 22:1295. [PMID: 36307843 PMCID: PMC9615190 DOI: 10.1186/s12913-022-08686-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background In the prevention and treatment of hypertension, patient education is an important measure to improve the awareness rate and control rate of patients. The professional and geographical advantages of community pharmacists enable them to play an important role in the patient education in hypertension. The purpose of this study was to understand the situation of patient education in hypertension conducted in Chinese community pharmacies, and put forward measures according to the problems. Methods A multi-stage competitive sampling by convenience was used to select community pharmacists working in community pharmacies in China for the study. Based on KAP theory, the first draft of the questionnaire was designed and the Delphi method was used to improve the questionnaire and a pre-study was conducted to test the reliability of the questionnaire. In January 2020, electronic questionnaires were distributed to 143 community pharmacists in Chinese community pharmacies. SPSS24 software was used for descriptive statistics and subgroup analysis of data. Results One hundred and eight valid questionnaires were collected, and the efficiency rate was 75.5%. Most of the respondents were younger than 30 years old (98.1%), and had bachelor’s degree (95.4%). In terms of knowledge, only 15.7% considered themselves "very good" and even 10.2% considered themselves "very bad". Only 35%-55% of respondents answered correctly for patient education content that requires more specialized knowledge, such as treatment and medication. Respondents generally had a positive attitude on the effect of hypertension patient education, but slightly less recognition of their role in patient education. In terms of practice, programs related to patient education have been conducted to different degrees. More than 30% of the community pharmacists interviewed implemented them occasionally or never. Conclusions Despite a positive attitude, most of the respondents did not have a high level of knowledge or practice. In China, more research evidence and new guidelines are needed to emphasize the importance and responsibilities of community pharmacists. Continuing education should be certificated at the national level and meet the various needs of community pharmacists. And salary incentives can be tried to motivate them.
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Lee EKP, Poon P, Yip BHK, Bo Y, Zhu MT, Yu CP, Ngai ACH, Wong MCS, Wong SYS. Global Burden, Regional Differences, Trends, and Health Consequences of Medication Nonadherence for Hypertension During 2010 to 2020: A Meta-Analysis Involving 27 Million Patients. J Am Heart Assoc 2022; 11:e026582. [PMID: 36056737 PMCID: PMC9496433 DOI: 10.1161/jaha.122.026582] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background Nonadherence to antihypertensive medications is the leading cause of poor blood pressure control and thereby cardiovascular diseases and mortality worldwide. Methods and Results We investigated the global epidemiology, regional differences, and trend of antihypertensive medication nonadherence via a systematic review and meta‐analyses of data from 2010 to 2020. Multiple medical databases and clinicaltrials.gov were searched for articles. Observational studies reporting the proportion of patients with anti‐hypertensive medication nonadherence were included. The proportion of nonadherence, publication year, year of first recruitment, country, and health outcomes attributable to antihypertensive medication nonadherence were extracted. Two reviewers screened abstracts and full texts, classified countries according to levels of income and locations, and extracted data. The Joanna Briggs Institute prevalence critical appraisal tool was used to rate the included studies. Prevalence meta‐analyses were conducted using a fixed‐effects model, and trends in prevalence were analyzed using meta‐regression. The certainty of evidence concerning the effect of health consequences of nonadherence was rated according to Grading of Recommendations, Assessment, Development and Evaluations. A total of 161 studies were included. Subject to different detection methods, the global prevalence of anti‐hypertensive medication nonadherence was 27% to 40%. Nonadherence was more prevalent in low‐ to middle‐income countries than in high‐income countries, and in non‐Western countries than in Western countries. No significant trend in prevalence was detected between 2010 and 2020. Patients with antihypertensive medication nonadherence had suboptimal blood pressure control, complications from hypertension, all‐cause hospitalization, and all‐cause mortality. Conclusions While high prevalence of anti‐hypertensive medication nonadherence was detected worldwide, higher prevalence was detected in low‐ to middle‐income and non‐Western countries. Interventions are urgently required, especially in these regions. Current evidence is limited by high heterogeneity. Registration URL: www.crd.york.ac.uk/prospero/; Unique identifier: CRD42021259860.
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Affiliation(s)
- Eric K P Lee
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Paul Poon
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Benjamin H K Yip
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Meng-Ting Zhu
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Chun-Pong Yu
- Li Ping Medical Library The Chinese University of Hong Kong Shatin Hong Kong
| | - Alfonse C H Ngai
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Martin C S Wong
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Samuel Y S Wong
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
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Ahmadi Z, Shahnazi H, Hassanzadeh A. Evaluation of medication adherence and its relevant factors among hypertensive patients: A cross-sectional study in Shahrekord health-care system. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:223. [PMID: 36177436 PMCID: PMC9514239 DOI: 10.4103/jehp.jehp_1332_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 10/26/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Medication adherence means compliance with patient adherence to medication orders, including timely and correct consumption of medication prescribed by a physician. The present study aimed to determine the extent of adherence to hypertension drug medication in patients covered by comprehensive health service centers of Shahrekord, Iran. MATERIALS AND METHODS A cross-sectional study examined 401 hypertensive patients registered in the Integrated Health Record System (SIB). SIB is a Persian term related to Health Record System. To collect data, Morisky Medication Adherence Scale was used. The questionnaire was completed by the patients and analyzed using SPSS (SPSS Inc., Chicago, Illinois, USA, version 26), Chi-square test, independent t-test, and analysis of variance. RESULTS The results indicated that adherence to antihypertensive medication was low in 5.7% of patients, while 63.3% of patients had sufficient compliance. Forgetting to take medications (52.9%) was the most common reason for nonadherence to medication in hypertensive patients. CONCLUSION Given that forgetting to take medications was the main reason for nonadherence to medication in hypertensive patients, designing and implementing necessary trainings by comprehensive health centers to realize the importance of daily use of medication by hypertensive patients and their families are recommended.
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Affiliation(s)
- Zabihallah Ahmadi
- Student Research Committee, Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Shahnazi
- Department of Health Education and Health Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akbar Hassanzadeh
- Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran
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Wolde M, Azale T, Debalkie Demissie G, Addis B. Knowledge about hypertension and associated factors among patients with hypertension in public health facilities of Gondar city, Northwest Ethiopia: Ordinal logistic regression analysis. PLoS One 2022; 17:e0270030. [PMID: 35714113 PMCID: PMC9205496 DOI: 10.1371/journal.pone.0270030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 06/02/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Hypertension is a disease that imposes risks of diseases on multi-system. Failure to control hypertension leads patients to end up with unavoidable complications, including death. Noncompliance to treatment is the main factor to develop such devastating complications whereas knowledge of patients about their disease is a key factor for better compliance. Thus, the purpose of this study is to assess the level of knowledge about hypertension and associated factors among hypertensive patients in public health facilities of Gondar city. METHODS Facility-based cross-sectional study was conducted between March and April 2019 in Gondar town. A systematic sampling technique was applied to select a total of 389 patients. A structured interview questionnaire was used to gather the data. The data were analyzed using STATA version 14. Ordinal logistic regression analysis was performed at P < 0.05 with a 95% confidence interval to identify statistically significant variables. RESULTS A total of 385 respondents participated giving a response rate of 98.9%. The majority (55.3%) of the patients had a low level of, 17.9% had a moderate level of knowledge whereas 26.8% had a high level of knowledge about hypertension. Those working in government organizations had 5.5 times higher odds of having a high level of knowledge than other groups (AOR = 5.5; 95%CI = 1.21, 25). Patients who received longer than four years of treatment showed twice larger odds of knowledge than those with below two years of treatment (AOR = 2; 95%CI = 1.29, 3.22) Moreover, patients residing proximate to the hospital increases the odds of having a higher level of knowledge by 1.64 times versus patients living far away from the hospital (AOR = 1.64, 95% CI = 1.07-2.63). CONCLUSIONS This finding revealed that knowledge about hypertension and risk factors among patients with hypertension was low. Employment in governmental organizations, longer duration of treatment, and residential proximity to hospitals/ health centers were statistically significant predictors of the participants' knowledge about hypertension. Therefore, it is important to give health education to patients working in non-governmental organizations and self-employed individuals about diseases and risk factors. In addition, emphasis should be given to patients receiving less than two years of treatment and coming from remote areas to improve their knowledge of the disease.
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Affiliation(s)
- Maereg Wolde
- Department of Health Education and Behavioral Sciences, College of Medicine and Health Science University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, College of Medicine and Health Science University of Gondar, Gondar, Ethiopia
| | - Getu Debalkie Demissie
- Department of Health Education and Behavioral Sciences, College of Medicine and Health Science University of Gondar, Gondar, Ethiopia
| | - Banchilay Addis
- Department of Health Policy and Health System, College of Medicine and Health Science University of Gondar, Gondar, Ethiopia
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11
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Lin SF, Kuo TT, Pan WH, Bai CH. Effects of socioeconomic status on the control of hypertension in patients <65 and ≥65 years of age in Taiwan: a nationwide cross-sectional study. BMJ Open 2022; 12:e050041. [PMID: 35197333 PMCID: PMC8867380 DOI: 10.1136/bmjopen-2021-050041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Implementation of National Health Insurance in 1995 improved the control of hypertension due to comprehensive coverage of medical costs for all residents in Taiwan. However, the role of individual socioeconomic status (iSES), namely, education and personal income, in awareness, treatmen, and control of blood pressure, has not been well studied in Taiwan. DESIGN A nationwide cross-sectional survey was executed in this study. SETTING A systematic, multistage sampling scheme from a nationwide cohort in Taiwan was adopted to select adult participants. Hypertension was defined as blood pressure ≥ 140/90 mm Hg or the use of antihypertensive medications. PARTICIPANTS A total of 4599 subjects completed door-to-door household interviews and physical examinations. PRIMARY AND SECONDARY OUTCOME MEASURES A summing z score of iSES was constructed by two domains of the iSES, namely, income and education, through which participants were classified into three SES levels. Logistic regression models were used to assess associations of awareness, treatment, and control in younger (<65 years) and older (≥65 years) participants with hypertension. RESULTS Younger people in the highest tertile of iSES were less likely to be aware of their hypertension (OR: 0.48, 95% CI: 0.37 to 0.64, p<0.0001) or to have it treated (OR: 0.49, 95% CI 0.37 to 0.64, p<0.0001) but more likely to have their hypertension controlled (OR: 1.52, 95% CI 1.19 to 1.94, p=0.0009). We did not detect an association in people aged >65 years. CONCLUSION Health education to improve awareness and treatment of hypertension should focus on younger people with higher iSES in Taiwan.
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Affiliation(s)
- Sheng-Feng Lin
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Tzu-Tung Kuo
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - W H Pan
- Institute of Biomedical Science, Academia Sinica, Taipei, Taiwan
| | - Chyi Huey Bai
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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Pan J, Hu B, Wu L, Li Y. The Effect of Social Support on Treatment Adherence in Hypertension in China. Patient Prefer Adherence 2021; 15:1953-1961. [PMID: 34522088 PMCID: PMC8434919 DOI: 10.2147/ppa.s325793] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/24/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Treatment nonadherence is a major problem in the management of hypertension. There are many factors influencing the treatment adherence of hypertensive patients. The aim of this study was to examine the effect of social support on the treatment adherence in hypertension in China. PATIENTS AND METHODS A total of 453 patients with hypertension hospitalized in a tertiary hospital in Xi'an, China were invited to participate in this cross-sectional study. Data were collected by "modified Chinese Hill-Bone compliance to high blood pressure therapy scale" and "Chinese Family Support Scale". RESULTS It was found that 31.1% of patients were adherent with their antihypertensive treatments. Gender, duration of antihypertensive drug used, number of antihypertensive drugs used and social support were independently associated with hypertensive treatment adherence. Social support was strongly and positively associated with the hypertensive treatment adherence (P<0.001, OR = 0.752, 95% CI: 0.678-0.833). Family social support was provided to hypertensive patients mainly through their nuclear family, that is spouses, partner or children. Treatment adherence of hypertensive patients was positively correlated to the three subgroups of social support. It was found that social support provided to patients from social resource (r=0.568) had greater impact on treatment adherence than that from kinship (r=0.364) and nuclear family (r=0.262). CONCLUSION Treatment adherence of patients with hypertension was found to increase positively as their social support increased. In addition to the support given to patients from nuclear family members, other social support especially professional agencies and community organizations should also be promoted and strengthened.
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Affiliation(s)
- Jingjing Pan
- Department of Pharmacy, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an, People’s Republic of China
| | - Bin Hu
- Department of Pharmacy, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an, People’s Republic of China
| | - Lian Wu
- Department of Ophthalmology, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an, People’s Republic of China
| | - Yarong Li
- Department of Pharmacy, School of Pharmaceutical Sciences, Xi’an Medical University, Xian, People’s Republic of China
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13
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Volpi SS, Biduski D, Bellei EA, Tefili D, McCleary L, Alves ALS, De Marchi ACB. Using a mobile health app to improve patients' adherence to hypertension treatment: a non-randomized clinical trial. PeerJ 2021; 9:e11491. [PMID: 34123593 PMCID: PMC8166239 DOI: 10.7717/peerj.11491] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/28/2021] [Indexed: 12/17/2022] Open
Abstract
Poor adherence to hypertension treatment increases complications of the disease and is characterized by a lack of awareness and acceptance of ongoing treatment. Mobile health (mHealth) apps can optimize processes and facilitate access to health information by combining treatment methods with attractive solutions. In this study, we aimed at verifying the influence of using an mHealth app on patients' adherence to hypertension treatment, also examining how user experience toward the app influenced the outcomes. A total of 49 participants completed the study, men and women, diagnosed with hypertension and ongoing medical treatment. For 12 weeks, the control group continued with conventional monitoring, while the experimental group used an mHealth app. From the experimental group, at baseline, 8% were non-adherent, 64% were partial adherents and 28% were adherent to the treatment. Baseline in the control group indicated 4.2% non-adherents, 58.3% partial adherents, and 37.5% adherents. After follow-up, the experimental group had an increase to 92% adherent, 8% partially adherent, and 0% non-adherent (P < 0.001). In the control group, adherence after follow-up remained virtually the same (P ≥ 0.999). Results of user experience were substantially positive and indicate that the participants in the experimental group had a satisfactory perception of the app. In conclusion, this study suggests that using an mHealth app can empower patients to manage their own health and increase adherence to hypertension treatment, especially when the app provides a positive user experience.
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Affiliation(s)
- Simiane Salete Volpi
- School of Physical Education and Physiotherapy, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Daiana Biduski
- Institute of Exact Sciences and Geosciences, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Ericles Andrei Bellei
- Institute of Exact Sciences and Geosciences, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Danieli Tefili
- School of Physical Education and Physiotherapy, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Lynn McCleary
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | | | - Ana Carolina Bertoletti De Marchi
- School of Physical Education and Physiotherapy, University of Passo Fundo, Passo Fundo, RS, Brazil.,Institute of Exact Sciences and Geosciences, University of Passo Fundo, Passo Fundo, RS, Brazil
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14
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Ajani K, Gowani A, Gul R, Petrucka P. Levels and Predictors of Self-Care Among Patients with Hypertension in Pakistan. Int J Gen Med 2021; 14:1023-1032. [PMID: 33790631 PMCID: PMC8006970 DOI: 10.2147/ijgm.s297770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/19/2021] [Indexed: 12/14/2022] Open
Abstract
Background Globally, hypertension is the leading non-communicable disease and strongest predictor of cardiovascular diseases. To mitigate and prevent hypertension-related complications, self-care behavior adaptation has proven to be vital. In this study, we examined the six clinically prescribed levels of self-care as prescribed by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and its predictors among a select sample of hypertensive individuals in Karachi, Pakistan. Methods This study reports the cross-sectional survey of a sequential mixed method study which assessed the levels of self-care of hypertensive individuals residing in an urban cosmopolitan setting within Karachi Pakistan. Four hundred and two patients were screened using the H-SCALE questionnaire, while socio-demographic predictors of self-care and level of knowledge of hypertension were identified using a study-specific checklist. Self-care was assessed against six clinical domains including medication adherence, diet, weight management, physical activity, and abstinence from alcohol. Results Participants were recruited from the two largest tertiary care hospitals in Karachi. Good knowledge about hypertension, including its causes, management, and complications was reported by 4.47% of the participants. Highest levels of self-care adherence were found for abstinence from alcohol (100%), smoking cessation (83.33%), and medication compliance (71.89%), whereas lowest levels were found for diet (27.11%), and physical activity (24.88%). In terms of predictors for self-care, age, male gender, and self-checking of blood pressure at home, followed by the level of education were the most common predictors for each self-care behavior in the given population. Conclusion Overall knowledge of self-care for hypertension is sub-optimal among hypertensive patients in Pakistan which is reflected in their behaviors. There is a need to introduce healthcare educational programs in Pakistan which can improve self-care behaviors of hypertensive individuals and potentially reduce the prevalence of associated cardiovascular diseases and its complications.
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Affiliation(s)
| | - Ambreen Gowani
- School of Nursing, Aga Khan University, Karachi, Pakistan
| | - Raisa Gul
- School of Nursing, Aga Khan University, Karachi, Pakistan.,School of Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Pammla Petrucka
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
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Ragavan RS, Joshi R, Evans RG, Riddell MA, Thankappan KR, Chow CK, Oldenburg B, Mahal AS, Kalyanram K, Kartik K, Suresh O, Thomas N, Mini GK, Srikanth VK, Maulik PK, Alim M, Guggilla RK, Busingye D, Thrift AG. Additive association of knowledge and awareness on control of hypertension: a cross-sectional survey in rural India. J Hypertens 2021; 39:107-116. [PMID: 32833918 DOI: 10.1097/hjh.0000000000002594] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine whether there is an interaction between knowledge about hypertension and awareness of hypertension on the treatment and control of hypertension in three regions of South India at different stages of epidemiological transition (see Video, Supplemental Digital Content 1, http://links.lww.com/HJH/B426). METHODS Using a cross-sectional design, we randomly selected villages within each of rural Trivandrum, West Godavari, and Chittoor. Sampling was stratified by age group and sex. We measured blood pressure and administered a questionnaire to determine knowledge and awareness of hypertension. Logistic regression was used to assess associations of awareness and knowledge about hypertension with its treatment and control in participants with hypertension, while examining for statistical interaction. RESULTS Among a total of 11 657 participants (50% male; median age 45 years), 3455 had hypertension. In analyses adjusted for age and sex, both knowledge score [adjusted odds ratio (aOR) 1.14 [95% confidence interval (CI) 1.12--1.17)] and awareness [aOR 104 (95% CI 82--134)] were associated with treatment for hypertension. Similarly, both knowledge score [aOR 1.10; 95% CI (1.08--1.12)] and awareness [aOR 13.4; 95% CI (10.7--16.7)], were positively associated with control of blood pressure in those with hypertension, independent of age and sex. There was an interaction between knowledge and awareness on both treatment and control of hypertension (P of attributable proportion <0.001 for each). CONCLUSION Health education to improve knowledge about hypertension and screening programs to improve awareness of hypertension may act in an additive fashion to improve management of hypertension in rural Indian populations.
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Affiliation(s)
| | - Rohina Joshi
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- George Institute for Global Health, Delhi, India
| | - Roger G Evans
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Australia
| | - Michaela A Riddell
- School of Clinical Sciences at Monash Health, Monash University, Melbourne
| | - Kavumpurathu R Thankappan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum
- Department of Public Health & Community Medicine, Central University of Kerala, Kasaragod, Kerala, India
| | - Clara K Chow
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Westmead Applied Research Centre, The University of Sydney, Sydney, New South Wales
- Department of Cardiology, Westmead Hospital, Sydney
| | - Brian Oldenburg
- Melbourne School of Population and Global Health, University of Melbourne
| | - Ajay S Mahal
- School of Public Health and Preventive Medicine, Monash University
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Kartik Kalyanram
- Rishi Valley Rural Health Centre, Chittoor District, Andhra Pradesh
| | - Kamakshi Kartik
- Rishi Valley Rural Health Centre, Chittoor District, Andhra Pradesh
| | - Oduru Suresh
- School of Clinical Sciences at Monash Health, Monash University, Melbourne
- Rishi Valley Rural Health Centre, Chittoor District, Andhra Pradesh
| | - Nihal Thomas
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, Tamil Nadu
| | - Gomathyamma K Mini
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Trivandrum, Kerala, India
| | - Velandai K Srikanth
- School of Clinical Sciences at Monash Health, Monash University, Melbourne
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Australia
| | - Pallab K Maulik
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- George Institute for Global Health, Delhi, India
- George Institute for Global Health -- Oxford University, Oxford, UK
| | - Mohammed Alim
- George Institute for Global Health, Delhi, India
- Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Rama K Guggilla
- Department of Population Medicine and Civilization Diseases Prevention, Faculty of Medicine with the Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, Bialystok, Poland
| | - Doreen Busingye
- School of Clinical Sciences at Monash Health, Monash University, Melbourne
| | - Amanda G Thrift
- School of Clinical Sciences at Monash Health, Monash University, Melbourne
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16
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Paczkowska A, Hoffmann K, Kus K, Kopciuch D, Zaprutko T, Ratajczak P, Michalak M, Nowakowska E, Bryl W. Impact of patient knowledge on hypertension treatment adherence and efficacy: A single-centre study in Poland. Int J Med Sci 2021; 18:852-860. [PMID: 33437222 PMCID: PMC7797540 DOI: 10.7150/ijms.48139] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 11/19/2020] [Indexed: 11/05/2022] Open
Abstract
Introduction: Recent studies show that treatment of arterial hypertension is unsuccessful. This is due to the patients' insufficient knowledge of about the therapeutic methods and the consequences of not treating arterial hypertension. Objectives: The aim of the study was to evaluate the patients' knowledge concerning therapeutic options, prophylaxis, and complications of arterial hypertension. The study also assessed the effect of such knowledge on hypertension treatment adherence and efficacy. Patients and Methods: The survey included 488 patients (250 female and 238 male), aged over 18 years, diagnosed with and treated in outpatient and inpatient settings at selected healthcare institutions in Poland. A custom-made questionnaire, based on references on this subject, was the key tool in the present study. Information about the course of the disease and evaluation of hypertension treatment efficacy was based on the patients' medical records. Results: The study found that 54.7% of the subjects had good knowledge about arterial hypertension, 40.0% had average knowledge, and 5.3% had poor knowledge. The extent of knowledge about the disease was significantly dependent on the level of education and the place of receiving medical care (p< 0.05). Good knowledge was significantly associated with controlled blood pressure, number of antihypertensive drugs used, frequency of hospitalization, as well as with medication adherence, and healthy lifestyle behaviours (p< 0.05). Conclusions: More than half of the patients presented good knowledge but a large group still had poor knowledge, especially patients with a low level of education and with hypertension treated at a general practitioner's clinic. The results of our study clearly show that knowledge about arterial hypertension affects medication adherence and healthy lifestyle behaviours and improves hypertension treatment efficacy.
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Affiliation(s)
- Anna Paczkowska
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences. Rokietnicka 7, 60-806 Poznan, Poland
| | - Karolina Hoffmann
- Department of Internal Diseases, Metabolic Disorders and Arterial Hypertension, Poznan University of Medical Sciences. Szamarzewskiego 84, 60-569 Poznan, Poland
| | - Krzysztof Kus
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences. Rokietnicka 7, 60-806 Poznan, Poland
| | - Dorota Kopciuch
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences. Rokietnicka 7, 60-806 Poznan, Poland
| | - Tomasz Zaprutko
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences. Rokietnicka 7, 60-806 Poznan, Poland
| | - Piotr Ratajczak
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences. Rokietnicka 7, 60-806 Poznan, Poland
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences Rokietnicka 7, 60-806 Poznan, Poland
| | - Elżbieta Nowakowska
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences. Rokietnicka 7, 60-806 Poznan, Poland
| | - Wiesław Bryl
- Department of Internal Diseases, Metabolic Disorders and Arterial Hypertension, Poznan University of Medical Sciences. Szamarzewskiego 84, 60-569 Poznan, Poland
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Prevalence and Associated Factors of Compliance Behaviors among Middle-Aged and Older Hypertensive Patients in China: Results from the China Health and Retirement Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197341. [PMID: 33050011 PMCID: PMC7579574 DOI: 10.3390/ijerph17197341] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 12/17/2022]
Abstract
Partial or total non-adherence has been recognized as major issues in the long-term management of hypertension. This study aims to investigate the prevalence and associated factors of compliance behaviors among Chinese middle-aged and older hypertensive patients. A sample of 6308 hypertensive patients aged ≥45 years was obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS) data. Two compliance behaviors were involved including medication and blood pressure monitoring. Stratified binary logistic regression analysis was employed to examine the associated factors. 77.2% of the participants reported medication compliance, and 40.7% complied with blood pressure monitoring. Better medication compliance associated with older age, overweight or obesity, one or ≥3 complications, no drinking, living in urban areas, and health education. Better blood pressure monitoring compliance associated with older age, overweight or obesity, ≥3 complications, normal activities of daily living (ADL), no smoking, sleep duration of 6–8 h, better cognitive function, living in urban areas, education level of middle school or above, and health education. Chinese middle-aged and older hypertensive patients experienced unoptimistic compliance behaviors, especially for blood pressure monitoring. Special attention and targeted interventions are urgent for the high-risk population of poor compliance behaviors, such as rural individuals, low educational population, and younger hypertensive patients.
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18
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Omoronyia O, Ayuk A, Nwafor K, Legogie A. Hypertensive patients' knowledge of cardiovascular disease in Calabar, Nigeria. J Egypt Public Health Assoc 2020; 95:16. [PMID: 32813101 PMCID: PMC7364754 DOI: 10.1186/s42506-020-00045-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 06/10/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND This study aimed at assessing knowledge of cardiovascular disease risk factors and prevention, among hypertensive patients in a developing country setting with high cardiometabolic disease morbidity and mortality. METHODS Using descriptive cross-sectional study design and random sampling method, a 30-item questionnaire was used to obtain quantitative data on knowledge of key aspects of cardiovascular disease and practice of preventive measures among hypertensive patients in Calabar. RESULT Two hundred and twelve (212) respondents were surveyed with mean age of 45.5 ± 10.8 years. Approximately two-thirds of respondents (67.9%) had unsatisfactory level of knowledge of CVD. Most respondents had unsatisfactory level of knowledge of appropriate diet (77.4%), basic epidemiology (80.2%), risk factors (63.2%), and symptoms of CVD (74.5%). The mean score for knowledge of risk factors was significantly higher among females compared with males (p < 0.05). Consumers compared with non-consumers of alcohol had significantly lower mean scores for knowledge of appropriate diet and symptoms of CVD (p < 0.05). Except for medical knowledge where mean score of knowledge was significantly higher among respondents occasionally exercised or consumed fresh fruits compared with other groups, there was no significant difference in mean score of knowledge for other components comparing the various categories of active exercise and consumption of fresh fruits (p > 0.05). CONCLUSION Unsatisfactory level of knowledge of cardiovascular disease among hypertensive patients in the study setting was high. There is urgent need to improve efforts and strategies for health education and counseling of patients toward sustainable adoption of preventive behaviors.
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Affiliation(s)
- Ogban Omoronyia
- Department of Community Medicine, University of Calabar, Calabar, Nigeria.
| | - Agam Ayuk
- Department of Family Medicine, University of Calabar, Calabar, Nigeria
| | - Kenneth Nwafor
- Department of Family Medicine, University of Calabar, Calabar, Nigeria
| | - Annette Legogie
- Department of Family Medicine, University of Calabar, Calabar, Nigeria
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Mekonnen CK, Mekonnen BY, Mekonnen HS. Knowledge and Associated Factors of Blood Pressure Control Among Hypertensive Patients Attending Chronic Illness Follow-Up Clinic at University of Gondar, Comprehensive Specialized Hospital, Northwest, Ethiopia. Vasc Health Risk Manag 2019; 15:551-558. [PMID: 31853180 PMCID: PMC6916695 DOI: 10.2147/vhrm.s225910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 11/21/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction As hypertension is a chronic cardiovascular disease that contributes to a high proportion of morbidity and mortality worldwide, favorable knowledge is crucial to control it. Objective The objective of this study was thus to assess knowledge and associated factors of blood pressure control among hypertensive patients at the chronic illness follow-up Clinic of the University of Gondar comprehensive-specialized hospital, Gondar, Ethiopia. Methods An institution-based cross-sectional study was conducted from March to April 2018. A systematic random sampling technique was used to select participants. Bi-variable and multivariable logistic regressions were done to assess the relationship between dependent and independent variables. The adjusted odds ratio with a 95% confidence interval was used to determine the presence and strength of association between covariates and the outcome variable. Results A total of 404 participants took part in the study with a response rate of 97.3%. The overall good knowledge about blood pressure control was 51.7% (95% CI=46.3-56.8). Females were 3.79 (AOR= 3.79, 95% CI: (1.55, 9.28)) more knowledgeable about blood pressure control than males. In the multivariable analysis, the odds of being knowledgeable were 2.80 (AOR= 2.80, 95% CI (1.44, 5.46)), 8.05 (AOR=8.05, 95% CI (2.93, 22.10)), and 7.53 (AOR=7.53, 95% CI (2.52, 22.49)) for can read and write, secondary, preparatory and above education, respectively, compared to cannot read and write. Occupation was significantly associated with the knowledge of plod pressure control. For example, merchants 7.66 (AOR=7.66, 95% CI (3.01, 19.47)), government employee 6.33 (AOR=6.33, 95% CI (1.90, 22.07)), and self-employed 4.58 (AOR=4.58, 95% CI (1.80, 11.70)) times more likely to be knowledgeable than farmers, respectively. Participants with family history of hypertension were 2.36 (AOR=2.36, 95% CI (1.42, 3.92)) times more knowledgeable than their counterparts. Conclusion In this study, knowledge of blood pressure control was lower compared to the finding of a study done at Bishoftu hospital, Ethiopia. But it is higher than studies in other African countries. Both pharmacological and non-pharmacological awareness is vital for blood pressure control.
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Affiliation(s)
- Chilot Kassa Mekonnen
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bezenaw Yimer Mekonnen
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habtamu Sewunet Mekonnen
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Xiao M, Lei X, Zhang F, Sun Z, Harris VC, Tang X, Yan L. Home Blood Pressure Monitoring by a Mobile-Based Model in Chongqing, China: A Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183325. [PMID: 31509950 PMCID: PMC6765873 DOI: 10.3390/ijerph16183325] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 12/27/2022]
Abstract
Purpose: Increasing attention is being paid to the role of the intelligent self-management of hypertension under the context of increasing prevalence but limited medical resources. However, heterogeneity in interventions and outcome measures has hindered the interpretation of research evaluating mobile health technologies for hypertension control, and little study of such technology has been performed in China. Objective: This was a feasibility study aimed to understand patient and medical practitioners’ acceptance and experience of a mobile-phone based platform for the management of hypertensive patients. Methods: The model used behavioral incentives for daily blood pressure measurement and physician-facing prioritization of patients based on level of blood-pressure control. Patients were enrolled by purposive sampling. The platform was used for two-week blood pressure monitoring through WeChat, which simulated our future app. Qualitative interviews with patients and providers were conducted in time. Results: Twenty hypertensive patients and two providers were enrolled and used the platform throughout the two weeks. Patients reported daily home blood pressure monitoring to be simple, feasible and increased their health awareness. Specifically, patients self-reported that reminders, the daily frequency and time of monitoring, and positive reinforcement were important for maintaining adherence. Providers reported that they could manage patients more quickly and accurately, but reasonable feedback information was needed to avoid excessive increases in workload. Conclusion: The adoption of mobile-based technology to monitor patient’s blood pressure may provide a practical solution for managing patients in Chongqing, China. Patient health education and enhanced app functionality could improve patient compliance and satisfaction while reducing provider workload.
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Affiliation(s)
- Meng Xiao
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Xun Lei
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Fan Zhang
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Zhenxing Sun
- Yuzhong Center for Disease Control and Prevention, Chongqing 400010, China.
| | - Vanessa Catherine Harris
- Amsterdam Institute for Global Health and Development and Department of Global Health University Medical Center, location AMC, University of Amsterdam, 1105 Amsterdam, The Netherlands.
| | - Xiaojun Tang
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Lijing Yan
- Global Health Research Center, Duke Kunshan University, Kunshan 215316, China.
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22
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Pan J, Wu L, Wang H, Lei T, Hu B, Xue X, Li Q. Determinants of hypertension treatment adherence among a Chinese population using the therapeutic adherence scale for hypertensive patients. Medicine (Baltimore) 2019; 98:e16116. [PMID: 31277112 PMCID: PMC6635171 DOI: 10.1097/md.0000000000016116] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To assess the adherence level of antihypertensive treatment and identify any associated risk factors in a sample of hypertensive patients from China.A cross-sectional study involving 488 Chinese hypertensive patients was conducted in a tertiary hospital in Xi'an, China. Data were collected regarding socio-demographic factors and hypertension-related clinical characteristics. The adherence to treatment was assessed using the previously validated instrument: therapeutic adherence scale for hypertensive patients.A total of 27.46% of patients were compliant with their antihypertensive treatments. Three factors were identified to be independently associated with antihypertensive treatment adherence: gender (P = .034), residence (P = .029), duration of high blood pressure (P < .001). Gender, residence, occupation, and the duration of antihypertensive drugs treatment used were found to have significant effects on treatment adherence in certain categories.Treatment adherence among hypertensive patients in China was poor. More attention and effective strategies should be designed to address factors affecting treatment adherence. Education about hypertension knowledge should be strengthened for patients. Moreover, the importance of lifestyle modification during hypertension treatment is often neglected by patients, therefore, there is an urgent need to educate hypertensive patients about the adherence to lifestyle modifications.
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Affiliation(s)
- Jingjing Pan
- Department of Pharmacy, Xi’an Fourth Hospital
- Xi’an Forth Hospital Affiliated Northwestern Polytechnical University
| | - Lian Wu
- Department of Ophthalmology, Xi’an Fourth Hospital
- Xi’an Forth Hospital Affiliated Northwestern Polytechnical University
| | | | - Tao Lei
- Department of Neurology, Xi’an Fourth Hospital, Xi’an, China
| | - Bin Hu
- Department of Pharmacy, Xi’an Fourth Hospital
| | | | - Qiongge Li
- Department of Pharmacy, Xi’an Fourth Hospital
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Nagarajan N, Jalal D. Resistant Hypertension: Diagnosis and Management. Adv Chronic Kidney Dis 2019; 26:99-109. [PMID: 31023454 DOI: 10.1053/j.ackd.2019.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 03/02/2019] [Accepted: 03/04/2019] [Indexed: 12/19/2022]
Abstract
Resistant hypertension is defined as high blood pressure requiring 3 or more medications for adequate control or controlled blood pressure requiring 4 or more medications. Considering the growing prevalence of hypertension and the strong link with cardiovascular disease, it is vital to understand the causes and treatment of resistant hypertension. This review article starts with an overview of the prevalence and little-known pathophysiology of resistant hypertension. Afterward, we discuss the evaluation and management of suspected secondary resistant hypertension in 2 broad categories: pseudoresistant hypertension and true resistant hypertension. Strategies for the identification and management of pseudoresistant hypertension are addressed. In addition, causes of true resistant hypertension, such as obstructive sleep apnea, primary aldosteronism, and renal artery stenosis, are examined along with their respective treatments. Finally, treatment of resistant hypertension is reviewed including pharmacologic treatments and novel procedural interventions for resistant hypertension. Overall, the review hopes to provide practitioners with a cohesive approach for the diagnosis and treatment of resistant hypertension.
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Adidja NM, Agbor VN, Aminde JA, Ngwasiri CA, Ngu KB, Aminde LN. Non-adherence to antihypertensive pharmacotherapy in Buea, Cameroon: a cross-sectional community-based study. BMC Cardiovasc Disord 2018; 18:150. [PMID: 30041606 PMCID: PMC6056997 DOI: 10.1186/s12872-018-0888-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 07/16/2018] [Indexed: 12/14/2022] Open
Abstract
Background Hypertension is a challenging public health problem with a huge burden in the developing countries. Non-adherence to antihypertensive treatment is a big obstacle in blood pressure (BP) control and favours disease progression to complications. Our objectives were to determine the rate of non-adherence to antihypertensive pharmacotherapy, investigate factors associated with non-adherence, and to assess the association between non-adherence and BP control in the Buea Health District (BHD), Cameroon. Methods A community-based cross-sectional study using stratified cluster sampling was conducted in the BHD from November 2013 – March 2014. Eligible consenting adult participants had their BP measured and classified using the Joint National Committee VII criteria. The Morisky medication adherence scale was used to assess adherence to BP lowering medication. Multivariable logistic regression models were used to predict non-adherence. Results One hundred and eighty-three participants were recruited with mean age of 55.9 years. Overall, 67.7% (95% CI: 59.8–73.6%) of participants were non-adherent to their medications. After adjusting for age, sex and other covariates, forgetfulness (aOR = 7.9, 95%CI: 3.0–20.8), multiple daily doses (aOR = 2.5, 95%CI: 1.2–5.6), financial constraints (aOR = 2.8, 95%CI: 1.1–6.9) and adverse drug effects (aOR = 7.6, 95%CI: 1.7–33.0) independently predicted non-adherence to anti-hypertensive medication. BP was controlled in only 21.3% of participants and was better in those who were adherent to medication (47.5% versus 8.2%, p < 0.01). Conclusion At least two of every three hypertensive patients in the Buea Health District are non-adherent to treatment. Forgetfulness, multiple daily doses of medication, financial constraints and medication adverse effects are the major predictors of non-adherence in hypertensive patients. These factors should be targeted to improve adherence and BP control, which will contribute to stem hypertension-related morbidity and mortality.
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Affiliation(s)
- Nkengla Menka Adidja
- Faculty of Health Sciences, University of Buea, Buea, Cameroon.,Djeleng Sub-divisional Hospital, Bafoussam, Cameroon
| | - Valirie Ndip Agbor
- Ibal Sub-divisional Hospital, Oku, Cameroon.,Faculty of Medicine & Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Jeannine A Aminde
- Faculty of Health Sciences, University of Buea, Buea, Cameroon.,Etoug-Ebe Baptist Hospital, Yaoundé, Cameroon
| | - Calypse A Ngwasiri
- Bamendjou District Hospital, Bamendjou, Cameroon.,Clinical Research Education, Networking & Consultancy (CRENC), Douala, Cameroon
| | - Kathleen Blackett Ngu
- Faculty of Medicine & Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Leopold Ndemnge Aminde
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Australia.
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Tan C, Hassali M, Neoh C, Saleem F, Horne R. Cultural Adaptation and Linguistic Validation of the Beliefs about Medicines Questionnaire in Malaysia. Value Health Reg Issues 2018; 15:161-168. [DOI: 10.1016/j.vhri.2017.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 11/29/2017] [Accepted: 12/03/2017] [Indexed: 02/08/2023]
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Pan J, Lei T, Hu B, Li Q. Post-discharge evaluation of medication adherence and knowledge of hypertension among hypertensive stroke patients in northwestern China. Patient Prefer Adherence 2017; 11:1915-1922. [PMID: 29200832 PMCID: PMC5700759 DOI: 10.2147/ppa.s147605] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The aims of this study were to assess the knowledge of hypertension (HTN) and investigate risk factors associated with medication adherence among hypertensive stroke patients after discharge in northwestern China. PATIENTS AND METHODS A cross-sectional study involving 440 Chinese hypertensive stroke patients was conducted in a tertiary hospital in Xi'an, China. Data were collected by telephone interviews and patients' medical records. RESULTS It was found that 35.23% of patients were compliant with their antihypertensive drug treatments, and 42.95%, 52.27% and 4.77% of patients had poor, moderate and adequate knowledge of HTN, respectively. Gender, blood pressure (BP) categories, BP monitoring and HTN knowledge were independently associated with antihypertensive medication adherence. CONCLUSION The medication adherence among hypertensive stroke patients in northwestern China was poor. Knowledge of HTN was suboptimal. More attention and effective strategies should be designed to the factors affecting medication adherence. As knowledge positively affects medication adherence, clinical pharmacists should play an important role in patients' medication education.
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Affiliation(s)
- Jingjing Pan
- Department of Pharmacy
- Correspondence: Jingjing Pan, Department of Pharmacy, Xi’an Fourth Hospital, 21 JieFang Road, 710004 Xi’an, People’s Republic of China, Tel +86 029 8748 0635 ext 029, Email
| | - Tao Lei
- Department of Neurology, Xi’an Fourth Hospital, Xi’an, People’s Republic of China
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