Image
A young woman in a pink shirt interacts with an elderly man in a traditional Nepali cap and jacket as they sit on modern chairs outdoors. Behind them, a serene forest landscape and a bright blue sky create a tranquil atmosphere
Project
Project Type - Pilot Projects

Challenges in Health Seeking Behavior Among Hypertensive Adults in Nepal

Addressing health barriers in hypertension
Southern Asia

Overview

Hypertension is highly prevalent and poorly controlled in older adults of Nepal. It is frequently reported as a modifiable risk factor to prevent dementia. In Nepal, over half of those receiving hypertension treatment still have uncontrolled blood pressure (BP), and more than 30% of older adults don’t seek healthcare despite health problems. 
 

Project Details

This study aims to identify BP control and explore the barriers and facilitators to health-seeking behavior among hypertensive older adults. A mixed-method, quantitative study will use secondary data from the “Dhulikhel Healthy City Initiative, 2021” (n=3,575). In preliminary analysis, we found 25.8% prevalence of HTN, with associated factors including age, sex, education, diabetes, and high cholesterol. Yunika Acharya will serve as the project coordinator, while Indu Poudel will act as the research assistant for this study.

We will list hypertensive patients and randomly contact them to gauge their interest in our research until we recruit 200 participants. Research assistants will conduct home visits for BP measurement and interviews to collect information on medication adherence (MA). A validated MA tool, the Hill Bone Medication Adherence Scale, will be used. A logistic regression model will include BMI, MA, age, sex, comorbidities, and history of smoking as covariates to predict BP control.

In-depth interviews and focus group discussions with various healthcare stakeholders—including hypertensive older adults, family caregivers, and healthcare workers—will explore barriers and facilitators of health-seeking behavior. Semi-structured interview guidelines will be used, and recorded data will be coded with NVivo software, followed by thematic analysis.

Investigators aim to determine BP control status and its associates, identifying potential barriers and facilitators related to the healthcare institution, individual factors, social support, and the healthcare system. Results will assist municipalities and health institutions in addressing barriers and promoting facilitators, ultimately improving healthcare access, BP control, and dementia prevention for hypertensive older adults. This study will also serve as a foundation to establish a geriatric clinic at Dhulikhel Hospital, Nepal, benefiting older adults through increased engagement with healthcare institutions to control BP and prevent dementia.