Consequences of hypertension and chronic obstructive pulmonary disease, healthcare-seeking behaviors of patients, and responses of the health system: a population-based cross-sectional study in Bangladesh

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Abstract

Abstract
BACKGROUND:
Non-communicable diseases are a threat to human health and economic development of low-income countries. Hypertension (HT) and chronic obstructive pulmonary disease (COPD) are two major causes of deaths, worldwide. This study assesses the health status, health-care seeking, and health provider responses among patients with these conditions.
METHODS:
The study carried out population-based cross-sectional survey in a rural and an urban surveillance area in Bangladesh. It interviewed all patients identified with HT and COPD at home using a structured questionnaire on the health consequences, healthcare-seeking behaviours, and coping strategies. Qualitative techniques identified key factors relating to the behaviours of patients and providers.
RESULTS:
COPD and HT correlate with lower activities of daily living (ADL) scores. The odds ratio (OR) for ADL scores in the combied conditions are high (OR: 3.04, p < 0.05) as compared to hypertension. Financial crises occur significantly more frequently among COPD patients in the urban site as compared to those in rural ares (12.5% vs. 2.4%, p < 0.01). Self-treatment at the onset is common. Seeking care from trained providers is higher in urban settings and is higher for HT. Referral for both COPD and hypertension was inadequate until the disease severity increased.
CONCLUSIONS:
COPD and HT significantly are associated with lower ADL scores and financial problems. Public-sector primary healthcare facilities should be better organised to address both conditions with the aim to reduce household poverty

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Chronic diseases--Bangladesh, Lungs--Diseases, Obstructive--Bangladesh, Lungs--Diseases, Obstructive--Prevention--International cooperation, Primary health care--Bangladesh, Hypertension--Bangladesh, Patient compliance
Journal or Publication Title: BMC Public Health
Publisher: BioMed Central Ltd.
ISSN: 1471-2458
Official Date: 3 June 2014
Dates:
Date
Event
3 June 2014
Published
28 May 2014
Accepted
18 February 2014
Submitted
Volume: Volume 14
Number: Number 1
Page Range: p. 547
DOI: 10.1186/1471-2458-14-547
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons open licence)
Date of first compliant deposit: 29 December 2015
Date of first compliant Open Access: 29 December 2015
Funder: National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (U.S.) (NIH)
URI: https://wrap.warwick.ac.uk/68324/

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