Hypertension care in Aseer region, Saudi Arabia: barriers and solutions.

The aim of this study is to assess the current situation of hypertension (HTN) care, to explore the barriers and to suggest the practical solutions to improve the quality of HTN care in primary health care centers (PHCC) in the Aseer region, KSA. This cross-sectional study was conducted in PHCCs in this region in 2010. Data collection sheets used to achieve the aims of this study consisted of three checklists, the first one derived from the quality assurance manual and HTN records used at the PHCCs giving details of the structural base of HTN care. Satisfaction with HTN care was assessed by using a five-point Likert scale questionnaire, while the third part was assessed by a checklist designed for the HTN care processes. Data were coded, entered and analyzed using SPSS version 16. The total number of HTN patients registered at PHCCs in Aseer region was 23,156 patients. Of them, 15,942 (69%) had files at PHCCs. Most of the essential infrastructures were acceptable, except training of doctors and nurses on HTN, which were 75% and 89%, respectively. About 40% of patients were on Beta blockers or ACE inhibitors and 30% were being given Aspirin in addition. HTN was uncontrolled among 45% of patients, while the defaulter rate was 22%. The rates of complications ranged from 0.7% for stroke to 7% for ischemic heart diseases. It was found that more than one-third of the patients had obesity and diabetes, while 10% suffered from dyslipidemia. Health teams were unsatisfied with the community participation (43%), patient compliance with appointment (32%) and coordination with hospitals (20%). They were satisfied with the health team (85%), while satisfaction with other items ranged from 60% to 75%. This study revealed that HTN patients received insufficient care, which could be attributed to many different barriers. In order to improve the quality of HTN care for HTN, these barriers should be overcome by implementation of the recommendations.