The Singapore Family Physician

Back to issue Vol 42 No. 3 - Advance Care Planning and End of Life Care

Patient and Provider Perspectives on Hypertension, Diabetes and Dyslipidemia Screening in a Low-income Singaporean Rental-flat Community

Wee Liang En
Gerald Koh Choon-Huat
The Singapore Family Physician Vol 42 No 3 - Advance Care Planning and End of Life Care
75 - 87
1 September 2016
0377-5305
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’ perceptions 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.