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Family support and medication adherence among residents with hypertension in informal settlements of Nairobi, Kenya: a mixed-method study

Journal of Human Hypertension volume 37, pages 74–79 (2023)Cite this article

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Abstract

Suboptimal medication adherence is a major barrier to hypertension control in Kenya, especially among informal urban settlement areas (sometimes referred to as “slums”). The few studies that have specifically explored medication adherence among this population have received discordant results, implying that additional factors which influence medication adherence merit further investigation. This study explores the relationship between family support and medication adherence among people with hypertension in informal settlements in Nairobi, Kenya. We conducted a quantitative survey followed up by semi-structured qualitative interviews. The sampling frame comprised two health facilities in informal settlement areas of the Korogocho neighborhood and participants were recruited via convenience sampling. We performed multiple logistic regressions for quantitative data and thematic analysis for qualitative data. A total of 93 people participated in the survey (mean age: 57 ± 14.7, 66% female). Most participants reported high family support (82%, n = 76) and suboptimal medication adherence (43% by the Morisky Scale; 76% by the Hill-Bone Scale), with no significant associations between family support and medication adherence. During interviews, many participants reported they lacked health knowledge and education. We suggest that the lack of health knowledge among this population may have contributed to a failure for family support to meaningfully translate into improvements in medication adherence. Our results underscore the need for further research to improve hypertension control among this uniquely disadvantaged population, especially with respect to the possible mediating influence of health education on family support and medication adherence.

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Acknowledgements

We acknowledge our collaboration with the African Population and Health Research Center in Nairobi, Kenya. We acknowledge the contributions of our local collaborators in Kenya for their strong intellectual and logistic support during the fieldwork.

Funding

This research was funded by Duke Kunshan University.

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Authors and Affiliations

  1. Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu Province, China

    Shangzhi Xiong, Nicholas Peoples, Shujun Fan & Lijing L. Yan

  2. Baylor College of Medicine, Houston, TX, USA

    Nicholas Peoples

  3. Global Health Institute, Duke University, Durham, NC, USA

    Truls Østbye & Lijing L. Yan

  4. Department of Internal Medicine, Holbaek Hospital, and Centre for Individualized Medicine in Arterial Diseases (CIMA), University of Southern Denmark, Odense, Denmark

    Michael Olsen

  5. Philips Research China, Shanghai, China

    Xuefeng Zhong

  6. African Population and Health Research Center, Nairobi, Kenya

    Caroline Wainaina & David Wambui

  7. Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA

    David Wambui

  8. School of Health Sciences, Wuhan University, Wuhan, China

    Lijing L. Yan

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  1. Shangzhi Xiong
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Contributions

SX, SF, and LLY conceived the study design, drafted the study protocol, and obtained ethical approvals. CW and DW led the data collection and cleaning. SX and NP conducted data analysis, interpretation, and led the writing. NP, TO, MO, and XZ provided critical suggestions to the structure and writing of the manuscript. All authors approved the submission for the final manuscript.

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Correspondence to Shangzhi Xiong.

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The authors declare no competing interests.

Ethical approval

The study was approved by the ethical committees of Duke Kunshan University, Africa Population Health Research Center (APHRC), and the Ethics and Scientific Research Committee of African Medical and Research Foundation (AMREF). Informed consent was obtained from each participant before they were involved in the study.

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Xiong, S., Peoples, N., Østbye, T. et al. Family support and medication adherence among residents with hypertension in informal settlements of Nairobi, Kenya: a mixed-method study. J Hum Hypertens 37, 74–79 (2023). https://doi.org/10.1038/s41371-022-00656-2

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