EXPLORING PATIENT EDUCATION EXPERIENCES AND PERCEIVED INFLUENCING FACTORS AMONG ADULTS WITH HYPERTENSION IN BOMET COUNTY’S PRIMARY CARE SETTING IN KENYA

Abstract

Hypertension is the leading cause of cardiovascular disease and the third leading cause of preventable deaths globally. Its burden is rising rapidly in low- and middle-income countries, with African nations affected profoundly. Kenya is experiencing a significant increase in prevalence, with nearly one-third of its population having hypertension, yet only 12% achieve adequate control. Bomet County, a rural region in Kenya, mirrors the national prevalence. Poor adherence to both pharmacologic and non-pharmacologic treatment is a key contributor to poor blood pressure control. One primary reason for this is limited patient knowledge about hypertension and its management. Effective patient education improves knowledge, is linked to better adherence, and independently improves health outcomes. Kenya‘s National Guidelines for Cardiovascular Disease Management identify patient education as a critical component of hypertension care, recommending that it be provided at every visit and that it cover lifestyle changes and medication adherence. It, however, remains unclear how consistently and effectively this is implemented in practice. Understanding patients‘ experiences is key to addressing potential gaps in patient education and improving hypertension care. This study aimed to explore the experiences of adult patients with hypertension in Bomet County regarding the education they receive, the sources and formats of that education, and their perceptions of the factors that influence effective patient education. It utilised a qualitative design, among adults aged 18–69 years diagnosed with hypertension at least three months prior. Participants were recruited through purposive sampling from primary care facilities and from clinics in referral centres. Data were collected through semi-structured interview guides for in-depth interviews, focus group discussions, and key informant interviews conducted between August and September 2025. Inductive coding was performed, and the data were analysed thematically using Dedoose. Five major themes were generated: Content and Quality of Education, Patient Perception and Adherence, Sources of Education, Interactions between Patients and Providers, and Patient Recommendations. Patients had varied experiences with the content, quality, and consistency of the education. Sources were formal (healthcare providers) who were strongly supported by community/informal sources (community health promoters and informal peer educators), either one-on-one or in community groups, and were influenced by multi-level factors, including patient, provider, community, and healthcare system factors. The findings suggest the need to develop appropriate, standardised, structured, easy-to-use educational tools and invest in community resources to enhance hypertension health education nationwide.