Acceptability of patient education for hypertension self-management among healthcare providers and beneficiaries in South Africa 2023-2024: A qualitative study

Abstract

Background The prevalence of hypertension is on the rise among people living with HIV (PLWH) in low- and middle- income countries. Previously tested interventions for integration of HIV and non-communicable diseases (NCD’s) such as patient education have been implemented in South Africa. However, knowledge of acceptability of those interventions remains low in the country. We explored the acceptability of patient education for hypertension self-management among PLWH and healthcare providers in Johannesburg, South Africa Methods An exploratory qualitative study using in-depth interviews guided by the theoretical framework of acceptability was conducted with 18 healthcare providers and 13 PLWH who have hypertension in Johannesburg. Audio recorded interviews were conducted in English, the theoretical framework of acceptability underpinned the study and guided analysis. MAXQDA version 22 was used for analysis. This is a sub-study of the Integrating HIV and hEART health in South Africa (iHEART-SA) trial (UH3HL156388). iHEART-SA is a hybrid type II effectiveness-implementation trial of a multicomponent intervention to control, identify and manage hypertension in PLWH. Results PLWH who have hypertension and healthcare providers accepted health education. The identified facilitators included the use of simple language, empowerment through knowledge, and perceived health improvements. However, emotional discomfort due to booklet colours, diagnosis denial, and staff shortages were identified as barriers of acceptability. Continued training was identified as a strategy to enhance acceptability. Conclusions Despite these barriers the intervention was highly accepted and considered effective, with calls for broader implementation and continuous training and digital tool integration to enhance patient education acceptability. Further research should refine and adapt these interventions for diverse populations.