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      Knowledge, attitudes and practices of hypertensive patients towards prevention and early detection of chronic kidney disease: a cross sectional study from Palestine

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          Abstract

          Background

          Hypertension is the second most common cause of chronic kidney disease (CKD). Therefore, the aims of the study were to assess the knowledge, attitudes and practices (KAP) of hypertensive patients towards prevention and early detection of CKD, and to determine the clinical and socio-demographic factors, which affect the KAP regarding prevention of CKD.

          Methods

          A cross-sectional study was held using the CKD screening Index to assess the KAP of 374 hypertensive patients who were selected from multiple primary healthcare centers in Nablus, Palestine. The CKD Screening Index is formed of three scales. First, the knowledge scale was a dichotomous scale of 30 items, while the attitude scale used 5-point Likert-type scale for 18 items and finally the practice scale was measured using 4-point Likert-type scale for 12 items. Multiple linear regression analysis was used to determine the association between clinical and socio-demographic factors and practices.

          Results

          In total, 374 hypertensive patients participated in the study. The mean age of participants was 59.14 ± 10.4 years, (range 26–85). The median (interquartile range) of the knowledge, attitude, and practice scores of hypertensive patients towards prevention and early detection of CKD were 20 (16–23), 69 (65–72), and 39 (36–42), respectively. In multiple linear regression analysis, patients age < 65 years ( p < 0.001) and patients with high education level ( p = 0.009) were the only factors significantly associated with higher knowledge scores. Additionally, patients age < 65 years ( p = 0.007), patients with high income ( p = 0.005), and patients with high knowledge score ( p < 0.001) were the only factors significantly associated with higher attitude scores. Furthermore, regression analysis showed that patients with higher total knowledge ( p = 0.001) as well as higher total attitudes scores towards CKD prevention ( p < 0.001), male gender ( p = 0.048), and patients with normal body mass index (BMI) ( p = 0.026) were statistically significantly associated with higher practice score towards CKD prevention.

          Conclusions

          Among hypertensive patients, higher scores for total knowledge and attitudes toward prevention, male sex, and normal BMI were associated with modestly higher scores for prevention practices. Finally the findings may encourage healthcare workers to give better counseling to improve knowledge.

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          Most cited references 27

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          Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression.

          The authors' goal was to examine the extent to which perceived stigma affected treatment discontinuation in young and older adults with major depression. A two-stage sampling design identified 92 new admissions of outpatients with major depression. Perceived stigma was assessed at admission. Discontinuation of treatment was recorded at 3-month follow-up. Although younger patients reported perceiving more stigma than older patients, stigma predicted treatment discontinuation only among the older patients. Patients' perceptions of stigma at the start of treatment influence their subsequent treatment behavior. Stigma is an appropriate target for intervention aimed at improving treatment adherence and outcomes.
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            Hypertension in overweight and obese primary care patients is highly prevalent and poorly controlled.

            Although the relationship between body weight and blood pressure (BP) is well established, there is a lack of data regarding the impact of obesity on the prevalence of hypertension in primary care practice. The objective of this study was to assess the prevalence of hypertension and the diagnosis, treatment status, and control rates of hypertension in obese patients as compared to patients with normal weight. A cross-sectional point prevalence study of 45,125 unselected consecutive primary care attendees was conducted in a representative nationwide sample of 1912 primary care physicians in Germany (HYDRA). Blood pressure levels were consistently higher in obese patients. Overall prevalence of hypertension (blood pressure >/=140/90 mm Hg or on antihypertensive medication) in normal weight patients was 34.3%, in overweight participants 60.6%, in grade 1 obesity 72.9%, in grade 2 obesity 77.1%, and in grade 3 obesity 74.1%. The odds ratio (OR) for good BP control (<140/90 mm Hg) in diagnosed and treated patients was 0.8 (95% confidence interval [CI] 0.7-0.9) in overweight patients, 0.6 (95% CI 0.6-0.7) in grade 1, 0.5 (95% CI 0.4-0.6) in grade 2, and 0.7 (95% CI 0.5-0.9) in grade 3 obese patients. The increasing prevalence of hypertension in obese patients and the low control rates in overweight and obese patients document the challenge that hypertension control in obese patients imposes on the primary care physician. These results highlight the need for specific evidence-based guidelines for the pharmacologic management of obesity-related hypertension in primary practice.
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              Comprehensive public health strategies for preventing the development, progression, and complications of CKD: report of an expert panel convened by the Centers for Disease Control and Prevention.

              Chronic kidney disease (CKD) is a public health threat in the United States, with increasing prevalence, high costs, and poor outcomes. More widespread effort at the prevention, early detection, evaluation, and management of CKD and antecedent conditions could prevent complications of decreased kidney function, slow the progression of kidney disease to kidney failure, and reduce cardiovascular disease risk. In 2006, the Centers for Disease Control and Prevention (CDC) launched an initiative on CKD. As part of this initiative, the CDC convened an expert panel to outline recommendations for a comprehensive public health strategy to prevent the development, progression, and complications of CKD in the United States. The panel adapted strategies for primary, secondary, and tertiary prevention for chronic diseases to the conceptual model for the development, progression, and complications of CKD; reviewed epidemiological data from US federal agencies; and discussed ways of integrating public health efforts from various agencies and organizations. The panel recommended a 10-point plan to the CDC to improve surveillance, screening, education, and awareness directed at 3 target populations: people with CKD or at increased risk of developing CKD; providers, hospitals, and clinical laboratories; and the general public. Cooperation among federal, state, and local governmental and private organizations will be necessary to carry out these recommendations.
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                Author and article information

                Contributors
                hala.saadeh146@yahoo.com
                razan.darwazeh@yahoo.com
                A.khalil@ju.edu.jo
                saedzyoud@yahoo.com , saedzyoud@najah.edu
                Journal
                Clin Hypertens
                Clin Hypertens
                Clinical Hypertension
                BioMed Central (London )
                2056-5909
                5 April 2018
                5 April 2018
                2018
                : 24
                Affiliations
                [1 ]ISNI 0000 0004 0631 5695, GRID grid.11942.3f, Department of Medicine, College of Medicine and Health Sciences, , An-Najah National University, ; Nablus, 44839 Palestine
                [2 ]ISNI 0000 0001 2174 4509, GRID grid.9670.8, Faculty of Nursing, , University of Jordan, ; Amman, Jordan
                [3 ]ISNI 0000 0004 0631 5695, GRID grid.11942.3f, Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, , An-Najah National University, ; Nablus, 44839 Palestine
                [4 ]ISNI 0000 0004 0631 5695, GRID grid.11942.3f, Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, , An-Najah National University, ; Nablus, 44839 Palestine
                [5 ]ISNI 0000 0004 0631 5695, GRID grid.11942.3f, Division of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, , An-Najah National University, ; Nablus, 44839 Palestine
                Article
                91
                10.1186/s40885-018-0091-7
                5885300
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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                © The Author(s) 2018

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