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Cluster | Number | Statement (number corresponds to item number on cluster map) |
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(1) Patient self-efficacy and support | 1 | Our patients are in denial and they fail to accept their condition |
3 | Lack of patient compliance to therapies: diet, medication, physical activity, and stress management (workplace, home, etc.) |
8 | The influence of peers or other patients with hypertension |
10 | Patients take multiple drugs |
11 | Our patients are not conscious of the amount of salt in their diet |
12 | The low educational level of our patients |
21 | Patients use alternative medication such as herbal, traditional, and spiritual interventions for blood pressure |
22 | Poor diet by patients |
23 | Patients experience stress of modern day life |
25 | Patient adoption of sedentary lifestyle |
28 | Our patients do not understand the severity of the disease |
32 | Patient nonadherence to medication |
33 | Cultural and religious barriers to medication use |
34 | Patients lack of family support with hypertension management |
39 | The health behaviors of the patients themselves |
40 | Patients increasingly patronize fast food |
41 | Patients experience side effects of high blood pressure medications |
43 | Patients think hypertension is curable after some time on medication |
51 | Patients are unable to take the different types of medication given because they are many |
54 | The preference for alternative medicines whose providers promise a cure rather than the control and lifetime management offered by physicians |
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(2) Physician-related issues | 2 | We do not address medication adherence with our patients |
5 | We do not discuss lifestyle activities like physical activity with our patients for blood pressure control |
6 | The inability of the physician to empathize and relate to/with his/her clients/patients |
7 | The age of the patient influences physicians ability to discuss blood pressure management |
9 | We do not adequately counsel our patients on ways to control their blood pressure |
14 | The failure of physicians to adopt a patient centered model in educating patients about their conditions |
18 | Our communication skills with our patients are poor which makes it difficult for them to comply with our instructions on blood pressure control |
19 | Not involving patients in decisions on modalities of treatments |
27 | We do not educate patients on the complications of hypertension |
42 | Health workers knowledge of blood pressure control is limited |
48 | The inability of physicians to identify comorbidities |
50 | Physicians lack knowledge and skills which probably will result in lack of confidence to treat these conditions in patients |
52 | Not taking into account patients opinion with regard to options for managing their blood pressure |
53 | Inertia on the part of clinicians to alter medications to achieve blood pressure control targets |
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(3) Policy level issues | 4 | Lack of comprehensive treatment protocols in most centers |
13 | We do not have the required equipment to provide the needed care for the management of high blood pressure |
15 | The healthcare institutions do not have adequate facilities to provide proper blood pressure services |
16 | Lack of adequate hospital follow-up |
17 | The long distance between the patient's home and the hospital makes it difficult for follow-up |
29 | The use of inaccurate BP monitoring machine |
30 | Lack of curricula as the ones available are largely based on infectious disease and little on conditions like hypertension |
31 | Primary healthcare systems are nonfunctional |
36 | The lack of standard protocol on blood pressure management in our primary health care systems |
37 | The availability of the right medication |
44 | The nonenforcement of standards of blood pressure treatment |
45 | Sometimes, equipment required to measure the blood pressure is either not available or not functional |
46 | High patient burden at hypertension clinics |
47 | Lack of policy or protocol by the Nigerian health sector on blood pressure control |
49 | Lack of standardization of blood pressure measurement in health care settings |
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(4) Economic factors | 20 | Patients paying out of pocket |
24 | Patients lack resources for follow-up care |
26 | Patients use fake drugs |
35 | Patients cannot afford the required medication |
38 | The cost and availability of blood pressure drugs |
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