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<p>The India Hypertension Control Initiative (IHCI) aimed to strengthen public sector primary care for hypertension treatment and control. Our study describes changes in health-seeking behaviour, prescription practices, and key predictors influencing treatment adoption in the public sector using data from IHCI repeat cross-sectional surveys. We conducted baseline (2018-19) and follow-up (2023-24) surveys in nine districts across five Phase I states in India - two districts each from Punjab, Madhya Pradesh, Telangana, and Kerala, and one from Maharashtra. We conducted the survey among 3,900 adults (18–69 years) per district at two time points. We computed frequencies and proportions for socio-demographic variables, healthcare utilisation, blood pressure (BP) control, drug availability, medication costs, and prescription practices. We used a log-binomial model to estimate unadjusted and adjusted prevalence ratios (PRs, APRs) with 95% confidence intervals for factors influencing care-seeking for hypertension in government facilities. Among 2,873 baseline and 3,276 follow-up respondents, the proportion seeking treatment at government facilities increased from 20% to 32%. Individuals on treatment were 1.5 times more likely to use government facilities in 2023-24 than in 2018-19 (aPR 1.54, 95% CI: 1.4–1.7). BP control improved in government (37% to 48%) and non-government (35% to 47%) facilities. Drug availability (always available) in government facilities rose from 72% (425/588) to 81% (844/1041), with Amlodipine 5&#xa0;mg remaining the most prescribed drug (18%). The proportion of individuals paying for medications dropped from 47% to 9%. There was increased public sector use, improved BP control, enhanced drug availability, and reduced costs, possibly due to IHCI interventions. We recommend using representative surveys for NCD surveillance to monitor healthcare utilisation patterns and assess the impact of interventions on hypertension outcomes. </p><p>Keywords</p><p>Blood Pressure; Hypertension; Public Sector; Primary Health Care; Drug Prescriptions; Patient Acceptance of Health Care; India</p>

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Changing patterns in health-seeking behaviour and prescription practices for treatment of hypertension in nine districts – insights from India Hypertension Control Initiative, 2018-19 and 2023-24

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月27日

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  • Prabhdeep Kaur,
  • Kalyani Sailesh,
  • Navaneeth S Krishna,
  • Mosoniro Kriina,
  • Santhiya Venkatesan,
  • Lakshmi Krishnan,
  • Jayashree Kalva,
  • Maanasa Rajagopalan,
  • Prajitha Kannamkottapilly Chandrasekharan,
  • Vettrichelvan Venkatasamy,
  • Sonie Sait,
  • Jayashree Somasundaram,
  • Sugavathy A,
  • Sailaja Bitragunta,
  • Meenakshi Sharma,
  • Roopa Shivashankar,
  • Pragati Pragya,
  • Sampada D Bangar,
  • Tapas Chakma,
  • Abhishek Kunwar,
  • Amol Wankhede,
  • Rupali Bharadwaj,
  • Vishwajit Bharadwaj,
  • Sravan Kumar Reddy T,
  • Navneet Kishore,
  • Bidisha Das,
  • Yannick Puthussery,
  • Deenadayalan Chandran,
  • Branch Immanuel A,
  • Sandeep S Gill,
  • Ashu Gupta,
  • Bipin Gopal,
  • Ramakrishna Kodirekkala,
  • Jagannath Reddy M,
  • Sarita Hazare,
  • Namita Neelkanth,
  • Gagandeep Singh Grover,
  • Anupam Khungar Pathni,
  • Parasuraman Ganeshkumar

摘要

The India Hypertension Control Initiative (IHCI) aimed to strengthen public sector primary care for hypertension treatment and control. Our study describes changes in health-seeking behaviour, prescription practices, and key predictors influencing treatment adoption in the public sector using data from IHCI repeat cross-sectional surveys. We conducted baseline (2018-19) and follow-up (2023-24) surveys in nine districts across five Phase I states in India - two districts each from Punjab, Madhya Pradesh, Telangana, and Kerala, and one from Maharashtra. We conducted the survey among 3,900 adults (18–69 years) per district at two time points. We computed frequencies and proportions for socio-demographic variables, healthcare utilisation, blood pressure (BP) control, drug availability, medication costs, and prescription practices. We used a log-binomial model to estimate unadjusted and adjusted prevalence ratios (PRs, APRs) with 95% confidence intervals for factors influencing care-seeking for hypertension in government facilities. Among 2,873 baseline and 3,276 follow-up respondents, the proportion seeking treatment at government facilities increased from 20% to 32%. Individuals on treatment were 1.5 times more likely to use government facilities in 2023-24 than in 2018-19 (aPR 1.54, 95% CI: 1.4–1.7). BP control improved in government (37% to 48%) and non-government (35% to 47%) facilities. Drug availability (always available) in government facilities rose from 72% (425/588) to 81% (844/1041), with Amlodipine 5 mg remaining the most prescribed drug (18%). The proportion of individuals paying for medications dropped from 47% to 9%. There was increased public sector use, improved BP control, enhanced drug availability, and reduced costs, possibly due to IHCI interventions. We recommend using representative surveys for NCD surveillance to monitor healthcare utilisation patterns and assess the impact of interventions on hypertension outcomes.

Keywords

Blood Pressure; Hypertension; Public Sector; Primary Health Care; Drug Prescriptions; Patient Acceptance of Health Care; India