[Usefulness of patient education in antihypertensive treatment compliance in black Africans]

Abstract

Aim of the study: To evaluate the compliance for antihypertensive treatment and to assess the effects of patient education as tool to improve the compliance in hypertensive patients.

Methods: We include prospectively all hypertensive patients followed in consultation in the cardiology department of the national police hospital in Ivory Coast. Compliance evaluation was made with the Girerd scale. After evaluation, all the patients benefit from an individual and/or collective education sessions. All the patients were followed and reevaluated after 1 year.

Results: We included consecutive 1000 hypertensive patients (mean age 40±20 years, 80 % male). Among these, 50 % have been treated by a single therapy, 30 % by a fixed double therapy and 25 % by a fixed triple combined therapy. At the start of the study, a low compliance is observed in 60 % of patients, 25 % have minimal problems of observance and 15 % are compliant. In 70 %, the low compliance may be explained by misconceptions and is associated with a persistent hypertension. One year after the education program, the compliance is improved: non-compliant patients represent 5 % of the population, 10 % having slight problems on compliance and 85 % have a good compliance.

Conclusion: In hypertension, the therapeutic compliance is poor, and associated with various factors. However, patient education improves the therapeutic compliance and this should be systematically proposed in antihypertensive management in Africa.

Keywords: Africa; Afrique noire; Compliance; Education; Hypertension; Hypertension artérielle; Observance; Therapeutic; Thérapeutique; Éducation thérapeutique.