title: An observational study of hypertension treatment and patient outcomes in a primary care setting.
abstract: BACKGROUND
  Evaluation and treatment of high blood pressure are vital to reducing hypertension-related morbidity. There are limited data on treatment of hypertension in Lesotho. The aim of this study was to investigate hypertension treatment and control in a primary care setting in Lesotho.
  
  
  METHODS
  A cross-sectional study was conducted among hypertensive patients treated at Domiciliary Health Clinic in Maseru, Lesotho between April and May 2013. We reviewed medical records and evaluated hypertension treatment and blood pressure control in the past 12 months. Patients were interviewed to assess adherence to hypertension treatment. Logistic regression analysis was used to identify factors associated with poor blood pressure control.
  
  
  RESULTS
  70 patients were enrolled in the study; 90.0% were female, the mean age was 57.7 years, 80.0% were overweight/obese and 27.1% had diabetes mellitus. 90.0% of the patients received combination antihypertensive therapy; the most frequently prescribed drugs were hydrochlorothiazide (90.0%), captopril (67.1%) and atenolol (51.4%). The majority of the patients had chronic uncontrolled hypertension. 67.2% of the patients had continuous access to antihypertensive drugs in the past 12 months; adherence to medication, diet and exercise was 64.3%, 37.1% and 7.1% respectively. Age ≥65 was the strongest independent predictor of poor blood pressure control (AOR = 10.3, 95% CI: 1.21-88.98, p = 0.033).
  
  
  CONCLUSIONS
  There is a need for interventions to improve hypertension care and outcomes in this setting. Efforts should be made to improve assessment of hypertensive patients, optimise antihypertensive therapy and promote patient adherence to treatment.
authors: Department of Pharmacy, National University of Lesotho, Roma, Lesotho.
authors: Keneuoe Hycianth
authors: KH
authors: Thinyane
authors: Department of Pharmacy, National University of Lesotho, Roma, Lesotho.
authors: Tumelo
authors: T
authors: Mothebe
authors: Department of Pharmacy, National University of Lesotho, Roma, Lesotho.
authors: Mopa
authors: M
authors: Sooro
authors: Department of Pharmacy, National University of Lesotho, Roma, Lesotho.
authors: Lekotoane David
authors: LD
authors: Namole
authors: Queen Mamohato Memorial Hospital, Maseru, Lesotho.
authors: Varsay
authors: V
authors: Cooper
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000600:supply & distribution / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007927:Lesotho; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011320:Primary Health Care; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents
keywords: Hypertension treatment; clinical outcomes; primary care