Patient perspectives on hypertension management in health system of Sri Lanka: a qualitative study

作者：Manuja Niranshi Perera, Chamini Kanatiwela de Silva, Saeideh Tavajoh, Anuradhani Kasturiratne, Nathathasa Vihangi Luke, Dileepa Senajith Ediriweera, Channa D Ranasinha, Helena Legido‐Quigley, H. Asita de Silva, Tazeen H. Jafar · 发表于：BMJ Open · 年份：2019 · DOI：10.1136/bmjopen-2019-031773 · 被引用次数：31 · 研究领域：Blood Pressure and Hypertension Studies、Healthcare Systems and Reforms、Global Public Health Policies and Epidemiology

INTRODUCTION: Uncontrolled hypertension is the leading risk factor for mortality globally, including low-income and middle-income countries (LMICs). However, pathways for seeking hypertension care and patients' experience with the utilisation of health services for hypertension in LMICs are not well understood. OBJECTIVES: This study aimed to explore patients' perspectives on different dimensions of accessibility and availability of healthcare for the management of uncontrolled hypertension in Sri Lanka. SETTING: Primary care in rural areas in Sri Lanka. PARTICIPANTS: 20 patients with hypertension were purposively sampled from an ongoing study of Control of Blood Pressure and Risk Attenuation in rural Bangladesh, Pakistan, Sri Lanka. METHOD: We conducted in-depth interviews with patients. Interviews were audio-recorded and transcribed into local language (Sinhala) and translated to English. Thematic analysis was used and patient pathways on their experiences accessing care from government and private clinics are mapped out. RESULTS: Overall, most patients alluded to the fact that their hypertension was diagnosed accidentally in an unrelated visit to a healthcare provider and revealed lack of adherence and consuming alternatives as barriers to control hypertension. Referring to the theme 'Accessibility and availability of hypertension care', patients complained of distance to the hospitals, long waiting time and shortage of medicine supplies at government clinics as the main b...