|
| Cluster | Number | Statement (number corresponds to item number on cluster map) |
|
| (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 |
|
| (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 |
|
| (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 |
|
| (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 |
|
