title: Prevalence and determinants of use of complementary and alternative medicine by hypertensive patients attending primary health care facilities in Kinshasa, Democratic Republic of the Congo: a cross-sectional study.
abstract: BACKGROUND
  In the Democratic Republic of the Congo the control of hypertension is poor, characterized by an increasing number of reported cases of hypertension related complications. Poor control of hypertension is associated with non-adherence to antihypertensive medication. It is well established that the use of complementary and alternative medicine is one of the main factors of non-adherence to antihypertensive medication. The aim of this study is to determine the prevalence and factors associated with the use of complementary and alternative medicine.
  
  
  METHODS
  A cross-sectional study was carried out at the Kinshasa Primary Health-care (KPHC) facilities network in November 2014. A structured interview questionnaire was administrated to a total of 280hypertensive patients. Complementary and alternative medicine were defined according to the National Institute of Health classification as a group of diverse medical and healthcare systems, practices, and products that are not presently considered to be part of conventional medicine. Data were summarized using proportion and mean (with standard deviation). The student's t test and χ2test were used respectively for mean and proportion comparison. Logistic regression analysis identified determinants of the use of complementary and alternative medicine.
  
  
  RESULTS
  The prevalence of use of complementary and alternative medicine was 26.1% (95% CI: 20.7% - 31.8%).Determinants of use of complementary and alternative medicine included misperception about hypertension curability (OR = 2.1; 95%CI: 1.1-3.7) and experience of medication side effects (OR = 2.9; 95%CI: 1.7-5.1).
  
  
  CONCLUSIONS
  The use of CAM for hypertensive patients is a major problem; antihypertensives with fewer side effects must be emphasized. Religious leaders must become involved in the communication for behavioral change activities to improve the quality of life for hypertensive patients.
authors.affiliation: Department of Epidemiology and Biostatistics, Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, PO Box11850, Kinshasa1, Democratic Republic of the Congo. aimelulebo@yahoo.fr.
authors.forename: Aimée M
authors.initials: AM
authors.lastname: Lulebo
authors.affiliation: Department of Epidemiology and Biostatistics, Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, PO Box11850, Kinshasa1, Democratic Republic of the Congo.
authors.forename: Mala A
authors.initials: MA
authors.lastname: Mapatano
authors.affiliation: Department of Epidemiology and Biostatistics, Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, PO Box11850, Kinshasa1, Democratic Republic of the Congo.
authors.forename: Paulin B
authors.initials: PB
authors.lastname: Mutombo
authors.affiliation: Department of Epidemiology and Biostatistics, Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, PO Box11850, Kinshasa1, Democratic Republic of the Congo.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Mafuta
authors.affiliation: Programme National de lutte contre les maladies tropicales négligées, Kinshasa, Democratic Republic of the Congo.
authors.forename: Gédéon
authors.initials: G
authors.lastname: Samba
authors.affiliation: School of Public Health, Université Libre de Bruxelles (ULB), Bruxelles, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Coppieters
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D000959:Antihypertensive Agents
keywords: Complementary and alternative medicine; DRC; Hypertension; Medication adherence