Adherence to hypertension treatment guidelines in state facilities in KwaZulu-Natal, South Africa.

Rationale, aims and objectives The province of KwaZulu-Natal, South Africa, embarked on the Essential Drugs Programme (EDP) consisting of standard treatment guidelines (STGs) and essential drugs lists in May 1999. The use of these tools was aimed at promoting rational drug use. This study sought to determine the percentage of compliance to the STGs of the EDP in the treatment of hypertension in patients in the district of eThekwini. Methods A retrospective cross-sectional randomized sampling of 100 prescriptions for hypertension per 21 health facility was conducted for the period of 3 months in 2007. Each prescription was assessed against modified World Health Organization indicators to determine compliance to STGs. Results The mean age of the sample was 55.235 years (+/-0.62). Hypertension featured as the most common diagnosis in the sample (57.5%). The mean result of compliance to the STGs for the eThekwini District was 22.05% (+/-20.03). The results of the multiple linear regression equation suggest that the variables selected in this study explain 86.79% of the variables impacting on treatment guideline adherence. Conclusion The low mean results for compliance to the STGs was due mainly to the absence of a diagnosis recorded on the prescription, and the addition of a new drug for each symptom without due consideration of polypharmacy, drug-disease and drug-drug interactions.