High rate of uncontrolled hypertension among adults receiving integrated HIV and hypertension care with aligned multi-month dispensing in Malawi: results from a cross-sectional survey and retrospective chart review

被引:0
|
作者
Whitehead, Hannah S. [1 ]
Phiri, Khumbo [2 ]
Kalande, Pericles [2 ]
van Oosterhout, Joep J. [1 ,2 ]
Talama, George [2 ]
Phiri, Sam [2 ,3 ]
Moucheraud, Corrina [4 ]
Moses, Agnes [2 ]
Hoffman, Risa M. [1 ]
机构
[1] UCLA, David Geffen Sch Med, Dept Med, 911 Broxton Ave Suite 301D, Los Angeles, CA 90024 USA
[2] Partners Hope, Lilongwe, Malawi
[3] Kamuzu Univ Hlth Sci, Sch Global & Publ Hlth, Lilongwe, Malawi
[4] NYU, Sch Global Publ Hlth, Dept Publ Hlth Policy & Management, New York, NY USA
关键词
HIV; hypertension; integrated care; Malawi; sub-Saharan Africa; multi-month dispensing; MIDDLE-INCOME COUNTRIES; ANTIRETROVIRAL THERAPY; INTERVALS; DISEASES; ART;
D O I
10.1002/jia2.26354
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Introduction: People living with HIV have high rates of hypertension. Integrated HIV and hypertension care with aligned multi-month dispensing of medications (MMD) could decrease the burden of care for individuals and health systems. We sought to describe hypertension control and evaluate its association with different durations of MMD among Malawian adults receiving integrated care with aligned dispensing of antiretroviral therapy (ART) and antihypertensive medication.<br /> Methods: We conducted a cross-sectional survey and retrospective chart review of adults (>= 18 >= 18 years) receiving integrated HIV and hypertension care on medications for both conditions for at least 1 year, with aligned MMD at seven clinics in Malawi. Data were collected from July 2021 to April 2022 and included socio-demographics, clinical characteristics, antihypertensive medications and up to the three most recent blood pressure measurements. Bivariate analyses were used to characterize associations with hypertension control. Uncontrolled hypertension was defined as >= 2 measurements >= 140 and/or >= 90 mmHg. Chart reviews were conducted for a random subset of participants with uncontrolled hypertension to describe antihypertensive medication adjustments in the prior year.<br /> Results: We surveyed 459 adults receiving integrated care with aligned dispensing (58% female; median age 54 years). Individuals most commonly received a 3-month aligned dispensing of ART and antihypertensive medications (63%), followed by every 6 months (16%) and every 4 months (15%). Hypertension control was assessed in 359 respondents, of whom only 23% had controlled hypertension; 90% of individuals in this group reported high adherence to blood pressure medications (0-1 - 1 missed days/week). Control was more common among those with longer aligned medication dispensing intervals (20% among those with 1- to 3-month dispensing vs. 28% with 4-month dispensing vs. 40% with 6-month dispensing, p = 0.011). Chart reviews were conducted for 147 individuals with uncontrolled hypertension. Most had high self-reported adherence to blood pressure medications (89% missing 0-1 - 1 days/week); however, only 10% had their antihypertensive medication regimen changed in the prior year.<br /> Conclusions: Uncontrolled hypertension was common among Malawian adults receiving integrated care with aligned MMD and was associated with shorter refill intervals and few antihypertensive medication escalations. Integrated care with aligned MMD is promising, but further work is needed to understand how to optimize hypertension outcomes.
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  • [1] Integrated care experiences and out-of-pocket expenditures: a cross-sectional survey of adults receiving treatment for HIV and hypertension in Malawi
    Moucheraud, Corrina
    Hing, Matthew
    Seleman, Juliet
    Phiri, Khumbo
    Chibwana, Florence
    Kahn, Daniel
    Schooley, Alan
    Moses, Agnes
    Hoffman, Risa
    [J]. BMJ OPEN, 2020, 10 (02):
  • [2] Preferences and uptake of mHealth supported multi-month ART distribution among adults living with HIV in rural Lesotho: a cross-sectional survey
    Lerotholi, M.
    Bally, S.
    Kopo, M.
    Lejone, T. Ishmael
    Motaboli, L.
    Kao, M.
    Chejane, N.
    Amstutz, A.
    Muhairwe, J.
    Labhardt, N. Daniel
    Tschumi, N.
    [J]. HIV MEDICINE, 2021, 22 : 242 - 242
  • [3] Impact of the 2017 ACC/AHA guidelines on the prevalence of hypertension among Indian adults: Results from a cross-sectional survey
    Gupta, Kartik
    Ramakrishnan, Sivasubramanian
    Zachariah, Geevar
    Rao, J. Shivkumar
    Mohanan, P. P.
    Venugopal, K.
    Sateesh, Santosh
    Sethi, Rishi
    Jain, Dharmendra
    Bardolei, Neil
    Mani, Kalaivani
    Kakar, Tanya Singh
    Jain, Vardhmaan
    Gupta, Prakash
    Gupta, Rajeev
    Bansal, Sandeep
    Nath, Ranjit K.
    Tyagi, Sanjay
    Wander, G. S.
    Gupta, Satish
    Mandal, Subroto
    Senguttuvan, Nagendra Boopathy
    Subramanyam, Geetha
    Roy, Debabatra
    Datta, Sibananda
    Ganguly, Kajal
    Routray, S. N.
    Mishra, S. S.
    Singh, B. P.
    Bharti, B. B.
    Das, Mrinal Kanti
    Deb, P. K.
    Deedwania, Prakash
    Seth, Ashok
    [J]. INTERNATIONAL JOURNAL CARDIOLOGY HYPERTENSION, 2020, 7
  • [4] Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey
    Sadosky, Alesia
    Schaefer, Caroline
    Mann, Rachael
    Bergstrom, Felicia
    Baik, Rebecca
    Parsons, Bruce
    Nalamachu, Srinivas
    Nieshoff, Edward
    Stacey, Brett R.
    Anschel, Alan
    Tuchman, Michael
    [J]. DIABETES METABOLIC SYNDROME AND OBESITY-TARGETS AND THERAPY, 2013, 6 : 79 - 92
  • [5] Geographical disparities in HIV prevalence and care among men who have sex with men in Malawi: results from a multisite cross-sectional survey
    Wirtz, Andrea L.
    Trapence, Gift
    Kamba, Dunker
    Gama, Victor
    Chalera, Rodney
    Jumbe, Vincent
    Kumwenda, Rosemary
    Mangochi, Marriam
    Helleringer, Stephane
    Beyrer, Chris
    Baral, Stefan
    [J]. LANCET HIV, 2017, 4 (06): : E260 - E269
  • [6] The Comparative Economic Burden of Mild, Moderate, and Severe Fibromyalgia: Results from a Retrospective Chart Review and Cross-Sectional Survey of Working-Age U.S. Adults
    Chandran, Arthi
    Schaefer, Caroline
    Ryan, Kellie
    Baik, Rebecca
    McNett, Michael
    Zlateva, Gergana
    [J]. JOURNAL OF MANAGED CARE PHARMACY, 2012, 18 (06): : 415 - 426
  • [7] Prevalence of hypertension and high-normal blood pressure among young adults in Zimbabwe: findings from a large, cross-sectional population-based survey
    Sabapathy, Kalpana
    Mwita, Fredrick Cyprian
    Dauya, Ethel
    Bandason, Tsitsi
    Simms, Victoria
    Chikwari, Chido Dziva
    Doyle, Aoife M.
    Ross, David
    Shah, Anoop
    Hayes, Richard J.
    Schutte, Aletta E.
    Kranzer, Katharina
    Ferrand, Rashida Abbas
    [J]. LANCET CHILD & ADOLESCENT HEALTH, 2024, 8 (02): : 101 - 111
  • [8] Sex-specific prevalence, inequality and associated predictors of hypertension, diabetes, and comorbidity among Bangladeshi adults: results from a nationwide cross-sectional demographic and health survey
    Ali, Nausad
    Akram, Raisul
    Sheikh, Nurnabi
    Sarker, Abdur Razzaque
    Sultana, Marufa
    [J]. BMJ OPEN, 2019, 9 (09):
  • [9] Obesity Among HIV-Infected Adults Receiving Medical Care in the United States: Data From the Cross-Sectional Medical Monitoring Project and National Health and Nutrition Examination Survey
    Thompson-Paul, Angela M.
    Wei, Stanley C.
    Mattson, Christine L.
    Robertson, McKaylee
    Hernandez-Romieu, Alfonso C.
    Bell, Tanvir K.
    Skarbinski, Jacek
    [J]. MEDICINE, 2015, 94 (27) : e1081