Evidence map›Paper›PMID 40100817›Full record

ArticlePLOS global public health2025

Acceptability of fixed-dose combination treatments for hypertension in Kenya: A qualitative study using the Theoretical Framework of Acceptability.

Daniel Mbuthia, Ruth Willis, Mary Gichagua, Jacinta Nzinga, Peter Mugo, Adrianna Murphy

Abstract read
In one paragraph

Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Daniel MbuthiaHealth Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.ORCID https://orcid.org/0000-0003-0021-305X
Ruth WillisDepartment of Health Services Research and Policy and Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, United Kingdom.ORCID https://orcid.org/0000-0001-9570-7436
Mary GichaguaDepartment of Health, Kiambu, Kenya.ORCID https://orcid.org/0009-0009-9866-2582
Jacinta NzingaHealth Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
Peter MugoHealth Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
Adrianna MurphyDepartment of Health Services Research and Policy and Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, United Kingdom.ORCID https://orcid.org/0000-0003-4065-6744

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Fixed-dose combinations (FDCs) - 2-3 anti-hypertensive medications in a single pill - have the potential to improve hypertension treatment and outcomes. Yet, they are not widely implemented. Factors undermining implementation remain unknown, particularly in sub-Saharan Africa, where hypertension is a major cause of disease burden and is poorly controlled. This study explored the acceptability of FDCs among patients, caregivers, and healthcare workers. We conducted semi-structured in-depth interviews with 58 participants from four purposively selected health facilities in Kiambu county, Kenya. Data were analyzed using an iterative thematic analysis approach, guided by the Theoretical Framework of Acceptability. Our findings indicate that FDCs are potentially acceptable to all participant groups. Acceptability is supported by the perception of FDCs as a means of reducing treatment burden (for patients and healthcare workers) and improving treatment adherence, and by patients' deferral to and trust in healthcare workers. However, acceptability among healthcare workers may be undermined by variable levels of knowledge about FDCs, concerns about FDCs as an "inflexible" treatment that does not allow dose titration or identifying causes of side effects, and concerns about inconsistent availability and affordability of FDCs in Kenya. To enhance acceptability and implementation of FDCs for hypertension treatment in Kenya, it is crucial to strengthen the capacity of all healthcare worker cadres to appropriately prescribe, inform patients about, and support adherence to FDCs. These efforts must align with broader initiatives to address upstream health system factors such as poor availability and affordability.

Identifiers

PMID40100817
PMCPMC11918355

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.