PATIENT AND PROVIDER PERSPECTIVES ON HYPERTENSION, DIABETES AND
DYSLIPIDAEMIA SCREENING IN A LOW-INCOME SINGAPOREAN RENTAL-FLAT COMMUNITY
- Author:
Liang En Wee
;
Gerald Choon-Huat Koh
- Publication Type:Journal Article
- Keywords:
Asia;
Cardiovascular;
Screening;
Low-income;
Qualitative
- From:The Singapore Family Physician
2016;42(3):75-87
- CountrySingapore
- Language:English
-
Abstract:
Aims:
Patient and provider barriers to cardiovascular disease
screening in disadvantaged Asian populations are
under-studied. We conducted a qualitative study of
attitudes to hypertension/diabetes/dyslipidaemia
screening within low-income communities in Singapore.
Methods:
Interviewers elicited barriers/enablers to blood
pressure measurement/fasting blood glucose/fasting
blood lipid amongst residents and healthcare providers
serving low-income communities. Transcripts were
analysed thematically and iterative analysis carried out
using established qualitative methodology.
Results:
Twenty patients and nine providers were interviewed.
Comments were grouped into seven content areas:
primary care characteristics (PCC), procedural issues,
knowledge, costs, priorities, attitudes, and information
sources. For hypertension screening, procedural issues
were enablers; however, for fasting blood tests,
procedural issues were perceived as both enablers and
barriers, including issues of pain, needle and blood
phobia, and lag between tests and results. Costs of
screening and treatment were cited as issues for
diabetes and cholesterol screening, but for
hypertension screening, concerns about cost of
treatment dominated. While blood pressure
measurement using sphygmomanometers and fasting
lipid tests were generally perceived as the accepted
screening tests for hypertension and hyperlipidaemia,
fasting glucose tests were not perceived as the accepted
screening test for diabetes. Barriers and enablers to
cardiovascular screening, as perceived by patients and
providers, were largely concordant.
Conclusion:
Procedural issues predominated in patients’ percept
ions of hypertension screening, while knowledge and
attitudes played a more significant role for diabetes
and dyslipidaemia. Interventions to raise screening
uptake in these disadvantaged communities must be
tailored to the main barriers for each modality.
