Patient knowledge, attitudes, and perceptions towards cardiovascular disease, medication compliance and lifestyle modifications in a tertiary hospital in Johannesburg

Abstract

Background and Aim: Cardiovascular disease (CVD) is the leading cause of mortality in sub- Saharan Africa and the leading cause of disability adjusted life years worldwide. The burden of CVD varies across countries with over three quarters of deaths occurring in lower-to-middle-income countries (LMICs). Despite the effectiveness of medication, adherence to therapy is a challenge. The paucity of information of CVD in South Africans and low cardiovascular literacy highlights the knowledge gaps of CVD disorders and the overlooked risk factors which are significant barriers. An analysis of the disparities in the vulnerable communities may guide the prioritization of interventions and allow disadvantaged groups to be reached. Therefore, this study aimed to determine patients’ knowledge, attitudes, and perception of their disease as well as the need for regular monitoring, medication compliance and the impact of lifestyle modification, in a public tertiary hospital in Johannesburg, South Africa. Methods: A cross-sectional study with convenience sampling was conducted in the vascular and diabetic outpatient clinics at a state tertiary hospital. A questionnaire was used to gather responses and a point of care test (POCT), assessing blood pressure, glycated hemoglobin (HbA1c) and lipogram was done to assess patient perception of their disease control. Results: Of the 191 participants (64%-woman, mean age 54 years), 57% were familiar with the term CVD, and 97% acknowledged the importance of follow-up visits. L evel of education, socio- economic status, monthly income, and residential area were associated with CVD knowledge levels. Participants with increased CVD knowledge were more physically active. Although the negative implications of smoking were acknowledged, they were not eager to quit. Participants with higher levels of knowledge were more aware of the indication of their medication. Patient’s perceptions of their disease were not aligned with the values measured by the POCTs. One-third of the population achieved target blood pressure levels and a quarter of the population achieved target HbA1c levels. Conclusion: Low to moderate levels of knowledge of CVD were found; most participants understood the significance of follow- up visits and treatment adherence. Insufficient knowledge of CVDs continues to be important factors in health behavior. Knowledge levels were influenced by the level of education, place of residence and type of employment, therefore targeted educational material may improve level of comprehension and understanding. Awareness strategies should emphasize at end organ damage is preventable and strategies to assist individuals to comprehend and manage the risk factors.