RPS Conference 2010, Abstracts 2010 - Royal Pharmaceutical Society

71
Barriers facing hypertensive patients in the United Arab Emirates when adhering to their
medication: a qualitative study
Ayesha Alqasem, Felicity Smith, Sarah Clifford
School of Pharmacy, University of London, London, United Kingdom
Focal points:
• This qualitative study aims to identify barriers to medication adherence among
Emirati hypertensive patients in the context of their social-cultural environment,
health beliefs and interaction with the healthcare system.
• Several themes were identified which may constitute barriers to adherence to
medications among hypertensive Emirati patients.
• Many reasons for non-adherence behaviour are context specific. This study
highlights the potential influence of factors such as health beliefs, local cultural
practices and interaction with the health system in the context of the Emirati
population in the UAE. An understanding of these factors is important if barriers
to adherence are to be addressed.
Introduction: Hypertension is one of the most common types of disease and a major public
health problem globally and in the UAE. WHO estimates the average rate of adherence to
antihypertensive medication to vary between 50 and 70%. 1 In hypertension, controlling blood
pressure is important in reducing the risk of cardiovascular disease, stroke and renal failure. A
study showed that patients who did not adhere to their beta-blocker therapy were at 4.5 times
more risk to have coronary heart disease than patients who did take the therapy. 2 Research in
the Middle East is scarce and applying the findings of the international research in the UAE are
expected to be of limited use as non-adherence likely influenced by the different culture, lifestyle
and health service provision in the UAE. This study aimed to identify barriers to medication
adherence among Emirati hypertensive patients in the context of their social-cultural
environment, health beliefs and interaction with the healthcare system.
Method: Ethical approval was obtained to carry out this study from the ministry of health in the
UAE. A Qualitative methodology was used because there have been no previous studies
exploring patients’ perceptions of illness and treatment or barriers to medication adherence
among hypertensive Emirati population. Hypertensive Emirati patients were recruited from
cardiology outpatient clinics of seven different hospitals in the UAE. Semi-structured interviews
were conducted, recorded digitally and transcribed in Arabic. Sampling continued until no new
themes appeared (saturation sampling) for a total of 20 participants. Qualitative framework
analysis was applied using the MAXQDA software package.
Results: Several themes were identified which may constitute barriers to adherence to
medications, including: a) A lack of information about hypertension and its treatment; b) Beliefs
about their medicines; c) Practical and emotional supports from family and friends d) Interaction
with the healthcare providers.
Decisions about the use of medicines were influenced by beliefs about the benefits of herbal
remedies. Conventional providers as well as the alternative medicine providers play an
important role in the disease management plan.