CHAPTER VI: CONCLUSION AND
RECOMMENDATIONS
VI.1 CONCLUSION
At the end of this study, we could say our different objectives
have been attained and the following points should be retained:
Sex ratio of participants was 1.2 with male predominance of
54.90%. The mean age was 60.1 #177; 11.1 years with extremes from 33 to 88 with
the 60 years and more, age group highly represented (48.60%). Most participants
(88.60%) lived in urban areas and 51.43% had a non-liberal profession,the
majority (66.30%) lived as couples and 40.00% had a higher level of education.
Trip duration to the hospital was less than one hour for 84.60% of
participants. The high socioeconomic status was greatly represented in this
study (60%) and 10.9% of participants had a health insurance.
The High Normal BP group was most represented (24.60%) and
57.70% had a controlled BP. The most frequently encountered comorbidity was
heart failure (24.57%). Only 18.29% of participants had a handicap.
Calcium channel blockers were the most encountered monotherapy
(31.90%). The majority of participants took less than 3 different
antihypertensive. The mean treatment cost was 14543 #177; 8613FCFA and most
participants were in the 10000-20000FCFA monthly drug cost range. More than 90%
of participants were on a once daily posology 65.70% were on monotherapy.
Specialty medications were prescribed in most cases (88.60%) and 38.30%
experienced side effects due to medication.
Poor adherence was observed in 32.60% of study
participants.After multivariate analysis with logistic regression, 9 variables
were significantly associated with poor adherence: first cycle secondary
education, living singly, trip duration of one hour or more, middle
socioeconomic status, uncontrolled BP status, presence of handicap,
monotherapy, presence of side effects, and taking medications in the
evening.
Of the 74 patients with uncontrolled BP, 86.49% had poor
adherence. Patients with uncontrolled BP were associated with poor therapeutic
adherence.
VI.2 RECOMMENDATIONS
At the end of this study, we formulate the following
recommendations:
· To the Ministry of Public Health,
1- To reinforce information, education and communication in
the whole country on non-communicable diseases especially hypertension, so that
patients should know the importance of adhering to antihypertensive treatments
prescribed.
2- To accelerate the implementation of the universal insurance
coverage in Cameroon so that patients could easily purchase their
antihypertensive drug prescribed.
· To Health Personnel,
1. Reinforce sensitization of patients with hypertension on
the need to adhere to their treatments which is lifelong in order to avoid
comorbidities and complications.
2. Insist on the need to prescribe generic drugs which are
less expensive in order to increase access and improve treatment adherence.
3. To opt for antihypertensive drugswhich have less side
effects and which are taken once daily to facilitate adherence.
CHAPTER VII:
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