Lifestyle Counselling and Blood Pressure Control among Hypertensive in a Primary Care Clinic; A Quasi-Experimental Study

Hypertension is a global health issue among the adult population with associated high morbidity and mortality rates. As the prevalence of hypertension increases in adult Nigerians, achieving target blood pressure (BP) control has become an importantmanagement challenge, especially with the adoption of western diet and lifestyle. Therefore, the aim of this study wasto determine the role of lifestyle counseling on BP control among hypertensives attending a general outpatient clinic at Federal Teaching Hospital, Ido-Ekiti. A Quasi-experimental study was performed on 322 adult patients (161 intheintervention group and 161 in the control group) with hypertension who had been on treatment for at least 3 months. Relevant data were collected using interviewer-administered semi-structured questionnaire. The 5As brief intervention for addressing health risk behaviour tool was used as a counseling guide only for the intervention group. The differences in the BP control between the intervention and control groups were statistically significant (p < 0.001) as more than two third of the intervention group 135(83.9%) had good BP control, compared to 68(42.2%) of the control group. Lifestyle counseling led to good BP control. Physicians will do well to counsel hypertensive patients on nutrition and lifestyle behaviour with a view to improving BP control in them

Role of footcare education in diabetic foot status and glycaemic control among diabetics attending family medicine practice of Federal Teaching Hospital Ido Ekiti

Background: Prevalence of type 2 diabetes among the adult population is rising globally. As the case detection rates of diabetes increase in adult Nigerians, managing the attendant (foot) complications has become an important health challenge. Poor practice of foot care and poor glycaemic control is potential risk for Diabetic Foot Ulcer (DFU).Objective: To determine the role of foot care education in diabetic foot status and glycaemic control among diabetics attending Family Medicine Practice, Federal Medical Centre, Ido Ekiti.Materials and Methods: Interventional study was performed on 154 adult patients (77 in intervention group and 77 in control group) with diabetes who had been on treatment for at least three months. Relevant data were collected using interviewer administered semistructured questionnaire. ''CARE framework'' tool was used as a patient education guide.Results: The practice of foot care in the intervention group improved to a statistically significant level compared to control group (85.7% vs 23.4%), p &lt; 0.001. There was no statistically significant difference in diabetic foot status between the intervention and the control group after the intervention. However, the glycaemic control was statistically significantly different between the two groups (p &lt; 0.001) post-intervention.Conclusion: Foot care education was linked to better foot care practice and improved glycaemic control. Family Physicians will do well by giving foot care education to diabetic patients with a view of improving foot care practice and glycaemic control, and reducing.Keywords: foot status, diabetic foot ulcer, diabetes, foot care, education, glycaemic contro

The role of physical exercise in management of depression among adult depressive patients attending family medicine practice of a Federal Teaching Hospital, South west Nigeria

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Relationship between patient satisfaction with medical care and medication non-adherence among hypertensive patients attending a general outpatient department in southwest Nigeria

Background: Medication non-adherence (MNA) is prevalent in hypertension. Patient satisfaction is derived from the patient's appraisal of how well the provider meets his or her personal emotional and physical needs. The objectives of this study were to determine the factors associated with medication non-adherence; and to also ascertain the relationship between patient satisfaction with medical care and medication non-adherence among hypertensive patients. Methods: Cross sectional study which was conducted in the Family Medicine clinic of the Federal Teaching Hospital, Ido-Ekiti. The sample size was 337. Morisky Medication Adherence Scale (MMAS-8), and the Patient Satisfaction Questionnaire (PSQ-18) were the questionnaires used. Data was analysed using the Statistical Package for Social Sciences (SPSS). Results: The majority {185 (54.9%)} of the hypertensives were in the age-group 45 – 64 years. The male to female ratio was 1:0.67. The largest proportion of the respondents {134 (39.8%)} had low adherence (medication non-adherence), while 104 (30.9%) and 99 (29.3%) had medium and high medication adherence level respectively. Mean satisfaction scores of 3 and above were obtained in the Technical Quality (3.54 ± 0.81), Accessibility and Convenience (3.48 ± 0.87), Communication (3.23 ± 0.95) and Interpersonal Manner (3.09 ± 0.98) subscales. The subscales with mean satisfaction scores of less than 3 were the General Satisfaction (2.82 ± 1.23), Financial Aspects (1.91 ± 0.82), and Time Spent with Doctor (1.85 ± 0.82) which had the least score. There were statistically significant strong positive correlations between medication adherence and each of the seven patient satisfaction subscales. The significant predictors of medication non-adherence were having primary education or no formal education,&nbsp; having monthly income of less than ₦50,000, and being overweight or obese. Conclusion: Physicians should deliver quality care in a way to achieve high ratings of patient satisfaction. This will influence patients to adhere better to their antihypertensive medications. Keywords: Patient satisfaction, medication non-adherence, blood pressure, hypertension, Nigeri

Relationship between patient satisfaction with medical care and medication non-adherence among hypertensive patients attending a general Outpatient Department in southwest Nigeria

Background: Medication non-adherence (MNA) is prevalent in hypertension. Patient satisfaction is derived from the patient's appraisal of how well the provider meets his or her personal emotional and physical needs. The objectives of this study were to determine the factors associated with medication non-adherence; and to also ascertain the relationship between patient satisfaction with medical care and medication non-adherence among hypertensive patients.Methods: Cross sectional study which was conducted in the Family Medicine clinic of the Federal Teaching Hospital, Ido-Ekiti. The sample size was 337. Morisky Medication Adherence Scale (MMAS-8), and the Patient Satisfaction Questionnaire (PSQ-18) were the questionnaires used. Data was analysed using the Statistical Package for Social Sciences (SPSS).Results: The majority {185 (54.9%)} of the hypertensives were in the age-group 45 – 64 years. The male to female ratio was 1:0.67. The largest proportion of the respondents {134 (39.8%)} had low adherence (medication non-adherence), while 104 (30.9%) and 99 (29.3%) had medium and high medication adherence level respectively. Mean satisfaction scores of 3 and above were obtained in the Technical Quality (3.54 ± 0.81),&nbsp; Accessibility and Convenience (3.48 ± 0.87), Communication (3.23 ± 0.95) and Interpersonal Manner (3.09 ± 0.98) subscales. The subscales with mean satisfaction scores of less than 3 were the General Satisfaction (2.82 ± 1.23), Financial Aspects (1.91 ± 0.82), and Time Spent with Doctor (1.85 ± 0.82) which had the least score. There were statistically significant strong positive correlations between medication adherence and each of the seven patient satisfaction subscales. The significant predictors of medication non-adherence were having primary education or no formal education,&nbsp; having monthly income of less than ₦50,000, and being overweight or obese.Conclusion: Physicians should deliver quality care in a way to achieve high ratings of patient satisfaction. This will influence patients to adhere better to their antihypertensive medications. Keywords: Patient satisfaction, medication non-adherence, blood pressure, hypertension, Nigeri

Relationship between Perceived Spousal Social Support and Blood Pressure Control among Hypertensive Patients Attending General Outpatient Clinic in Federal Teaching Hospital, IdoEkiti, Nigeria

Background: Despite many approaches to control hypertension, a lot of people still experience challenges keeping their Blood Pressure (BP) under control, and because the condition requires life - long treatment, many patients will need additional effort from their spouses. The spouse shares intimacy with patient and is the chief source of social support that provides fi nancial assistance, reminds and encourages medication use, shows concern and interest by discussing issues related to the disease. Therefore, exploring the relationship between Perceived Spousal Social Support (PSSS) and BP control will help the physician and other stakeholders harness the gains of this association to achieving BP control, prevent complications and death associated with hypertension. Objective: To identify the relationship between perceived spousal social support and blood pressure control among hypertensive patients attending General Outpatient Clinic (GOPC) in Federal Teaching Hospital, Ido-Ekiti, Nigeria. Materials and methods: This was a hospital - based cross - sectional study carried out between June and August 2016 among 298 hypertensive patients aged 18 and 65 years attending GOPC of the Federal Teaching Hospital, Ido Ekiti. Collection of data was done using pre-tested, semi-structured questionnaire on sociodemographic characteristics, blood pressure measurement and 4-point Likert Social Support questionnaire to measure the perceived spousal social support. Data was analysed using SPSS IBM version 17.0. Results: Mean age of respondents was 56.0 ± 8.5 years and seventy percent were females with male to female ratio of 1:2.3. Less than half of the respondents, 47.7% and about half of the respondents, 50.3% achieved BP control and demonstrated strong PSSS respectively. There was statistically signifi cant relationship between PSSS and BP control (χ2 = 27.05, p < 0.001). Conclusion: Social support perceived by participants positively infl uenced their BP control. Family Physicians and other health care providers should therefore determine and enhance the level of this support and encourage spouses to provide this support for their partners who have hypertension or those having diffi culty controlling their BP despite the appropriate use their medications