Treatment status and experiences of hypertension patients at a large health center in Cape Town.

OBJECTIVE: This study was undertaken at a community health center (CHC) in the Cape Peninsula in order to assess the treatment status, knowledge and experiences of hypertensive patients. In addition, a health indicator sheet for hypertension was evaluated and an attempt was made to identify predictors of blood pressure (BP) control at this clinic. METHODS: Two hundred two hypertensive patients were selected by interviewing the first available hypertensive patients. The patients' BP was measured electronically and by sphygmomanometer, and was compared to that recorded by the clinician on their clinic folders; heights and weights were also determined. RESULTS: Of the hypertensives, 41.6% had a BP above 160/95 mm Hg and only 42.1% had a BP below 140/90 mm Hg. Patients had little knowledge of either the consequences of hypertension or the actions needed to ensure that complications were prevented; 31% suggested home remedies for hypertension. The majority of the patients were satisfied with the service they received, but 47% complained about long waiting times, 37% felt that the doctor did not examine them adequately, and 15.5% reported that insufficient medication was provided when filling prescriptions. Urine and eye tests had been conducted infrequently during the previous two years. Thirty percent of the patients requested the return of the dedicated hypertension clubs. Conditional logistic regression models identified that patients who expressed the need to make proposals to the clinic staff about their care had better BP control than those who did not. CONCLUSIONS: The BP of hypertensive patients is not optimally controlled at this CHC and both non-drug and drug management of hypertension need to be improved. Steps should be taken to help hypertensive patients become more knowledgeable so that they may play more active and compliant roles in their hypertension care. Patients also suggested that dedicated hypertension clubs be reinstituted at the CHCs.