RESUMO
The proportion of poorly controlled hypertensives still remains high in the general African population. This is largely due to therapeutic inertia (TI), defined as the failure to intensify or modify treatment in a patient with poorly controlled blood pressure (BP). The objective of this study was to identify the determinants of TI. We conducted a retrospective cohort study from March 2012 to February 2014 of hypertensive patients followed during 4 medical visits. The TI score was the number of visits with TI divided by the number of visits where a therapeutic change was indicated. A random-effects logistic model was used to identify the determinants of TI. A total of 200 subjects were included, with a mean age of 57.98 years and 67% men. The TI score was measured at 85.57% (confidence interval [CI] 95%â =â [82.41-88.92]). Measured individual heterogeneity was significantly significant (0.78). Three factors were associated with treatment inertia, namely the number of antihypertensive drugs (odd ratios [OR]â =â 1.27; CIâ =â [1.02-1.58]), the time between consultations (ORâ =â 0.94; CIâ =â [0.91-0.97]), and treatment noncompliance (ORâ =â 15.18; CIâ =â [3.13-73.70]). The random-effects model performed better in predicting high-risk patients with TI than the classical logistic model (P valueâ <â .001). Our study showed a high TI score in patients followed in cardiology in Burkina Faso. Reduction of the TI score through targeted interventions is necessary to better control hypertension in our cohort patients.
Assuntos
Hipertensão , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Estudos Retrospectivos , Hipertensão/tratamento farmacológico , Anti-Hipertensivos/uso terapêutico , Anti-Hipertensivos/farmacologia , Pressão Sanguínea , África Ocidental , Sistema de RegistrosRESUMO
Unmet need for family planning (UNFP) remains a public health concern in Angola. The objective of this study was to analyze the factors associated with UNFP among Angolan women aged 15-49 years in 2015-2016. This was an analytical cross-sectional study. A multiple logistic regression model using data from the Angola Demographic and Health Survey 2015-2016 was performed to determine the associated factors. In total, the study involved 8033 women, 22% of whom were between 25-29 years of age. A large number (65%) lived in urban areas and 39% had primary education. About 1/4 of the women (26%) had UNFP for birth spacing. Associated factors were multiple. Age, credible source of information on family planning were protective factors against UNFP for birth spacing while economic level, the woman's level of education were risk factors for NFP.