Barriers to Self- Monitoring; A Study Among Hypertensive Patients in Accra Metroplis

Abstract

Hypertension is a global public health problem that is ravaging the active adult workforce of nations especially in low- and middle-income countries such as Ghana. Health care professionals continue to roll out management interventions aimed at controlling blood pressures and improving patients’ well-being. Regular self-monitoring of blood pressure by hypertensive patients is one sure way of improving their health. The practice of self-monitoring in the general population or among hypertensive patients in Ghana is not documented. However, anecdotal evidence suggests that some people, especially patients, perform self-monitoring. This study sought to explore their awareness and knowledge about self-monitoring, how they practice it and any barriers to the practice. This was a cross-sectional quantitative study where hypertensive patients who regularly attended Specialist Hypertension OPD clinics at Ridge Regional Hospital and La General Hospital in the Accra Metropolis formed the study population. A structured questionnaire was administered by interviewers or self-administered during patients’ normal visits to their physicians for review. Data analysis was done using STATA Statistical/Data Analysis software, version 12.0 (Special Edition). A total of 354 respondents, involving 162 males (45.8%) and 192 females (54.2%) took part in the study, majority of whom were aged between 30 and 60 years (median=50). Only a few respondents (7.1%) had lived with hypertension for 20 years and more, with diabetes affecting 28% of them. This study found that 67.8% of respondents had heard about SMBP, with health workers (70.4%) being their main source of information. The proportion of respondents who were currently self-monitoring with their personal BP apparatus was 31.9%, and less than 1% was practicing SMBP correctly. The main barriers to the practice of self-monitoring identified were lack of awareness and lack of money to purchase a personal BP apparatus. Awareness about self-monitoring among respondents was high. About a third of them were self-monitoring, but almost all of whom were practicing incorrectly. Patients inability to practice were largely personal, but was also influenced by access to information/education from HCP.