Family functioning and adherence to medication: A study of hypertensive in a tertiary hospital, South Western Nigeria

Background: Hypertension is one of the most important risk factors for coronary heart disease, stroke, heart failure, and end-stage renal disease. It remains an important public health challenge, despite effective medical therapies for its management, patients' poor adherence remains a global problem. Aim: The main objective of this study is to determine the relationship between family functioning and medication adherence among hypertensive, attending a tertiary care center in South-West Nigeria. Materials and Methods: This was a descriptive cross-sectional study. The systematic sampling method was used to select 420 patients attending the outpatient clinic of the tertiary hospital. Relevant data were collected using interviewer-administered pretested semi-structured questionnaires. Results: Four hundred and twenty people participated in the study. The mean age of respondents was 60.97 ± 11.28 years, and a slight female preponderance (M:F = 1:1.7). Three hundred and forty-nine (83.1%) were married, 273 (65.0%) were from a monogamous family and 375 (89.2%) had a family size of >4. More than half of the study participants had a functional family (66.4%) and were adherent (61.2%) to their medication. Increased medication adherence proportion was observed in patients with a functional family. Adherence to medication is three times (odds ratio = 2.585, 95%CI = 1.636, 4.084) higher among patients with functional family. Conclusion: The structure and nature of family relationships, both of which determines family functioning, are important to medication adherence. A functional family enhances adherence to medication. Primary care physicians should create a positive treatment alliance with their patients to better family functioning

Community-acquired pneumonia and its predictors of mortality in rural southwestern Nigeria: A-five year retrospective observational study

Introduction: The predictors of community-acquired pneumonia (CAP) mortality are important outcome measures in epidemiological studies and clinical trials. There is an observed paucity of data regarding the predictors of mortality of CAP in Nigeria. Few studies from the urban centres have been reported in the literature, with none from the rural centres. The objective of this study is to ascertain the clinical presentations, risk factors, and predictors of mortality among patients admitted for CAP in rural Southwestern Nigeria. Methods: A retrospective observational study using a data form and a standardised questionnaire reviewed the 176 patients admitted to Southwestern Nigeria hospital between January 2015 and December 2019. The data were analysed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Results: A total of 176 patients were studied. Their mean age was 53.3±16.8 years. There were more males, 112 (63.6%), than females. The most common clinical presentations were cough, fever and sputum expectoration. The case fatality rate was 9.1% and its predictors were older aged patients [Adjusted Odds Ration (AOR), 4.135: 95% Confidence Interval (CI) (1.389-12.315); p =0.005], hypoxia [AOR, 11.118: 95% CI (2.607-47.405); p<0.001], tobacco smoking [AOR, 3.632: 95% CI (1.459-9.039); p=0.008], chronic obstructive pulmonary disease (COPD) [AOR, 10.111: 95%CI (2.370-43.139); p <0.001], and human immunodeficiency virus (HIV) [AOR, 9.444: 95% CI (4.304-20.725), p<0.001]. Conclusion: The case -fatality rate was 9.1%, and its predictors were older age patients, patients with hypoxia, tobacco smoking, COPD, and HIV. This study strengthens the argument on the higher prevalence of CAP and its mortality in rural Southwestern Nigeria. The findings may provide an impetus for prospective research on these outcomes

Blood pressure control and its associated factors among hypertensive patients in federal teaching hospital, ido- ekiti, Southwest Nigeria

Background: Hypertension is a modifiable risk factor for cardiovascular disease, stroke and renal disease worldwide. Despite improvement in treatment modality and therapeutic intervention, with proven benefits in reducing the burden of uncontrolled hypertension, majority of peoples’ blood pressure still remain uncontrolled.&nbsp;Aim: To assess the patterns of blood pressure control and its associated factors among hypertensive patients on follow-up.Setting: This study was done at the general out-patient department of Federal Teaching Hospital, Ido- Ekiti, Southwest Nigeria, which is a referral centre for private and government owned - health facility in the state and its environs.Methods: Hospital-based cross sectional study was conducted from June 4 – August 31, 2019. Systematic random sampling method was used to select the 320 participants. Semi-structured interviewer- administered questionnaire was used to seek information on participants’ socio-demographic characteristics, lifestyle changes and level of adherence to antihypertensive medication. Blood pressure was measured and recorded. Data was analyzed using SPSS 20. Multivariate logistic regression analysis was used to identify the factors associated with poor blood pressure control.Results: Mean age of the participants was 63.9± 11.5 years. 56.6% had their blood pressure controlled within the recommended limits. In multivariate analysis, civil servant (OR =45.160, 95% CI: 6.143 – 332.000) and adherence to medication (OR=15.35, 95% CI: 6.303 – 37.391) were the independent associated factors with good blood pressure control while old age (OR= 0.894, 95% CI: 0.837- 0.955) and diabetes (OR= 0.072, 95% CI: 0.016-.0,318) were independent associated factors with poor blood pressure control.Conclusions: Old age and diabetes are the predictors of poorly controlled blood pressure and therefore, clinicians and other stakeholders should provide close attention and targeted blood pressure control among this set of patients.</p