Perceived Barriers and Facilitators in Cardiovascular Risk Management in Colombia: A Qualitative Analysis of the RE-HOPE Study

Jose P. Lopez-Lopez, Yesica Giraldo-Castrillon, Johanna Otero, Claudia Torres, Alvaro Castañeda-Hernandez, Daniel Martinez-Bello, Claudia Garcia, Marianne Lopez-Cabrera and Patricio Lopez-Jaramillo ()
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Jose P. Lopez-Lopez: Masira Research Institute, Universidad de Santander (UDES), Bloque G, piso 6, Bucaramanga 680003, Colombia
Yesica Giraldo-Castrillon: Masira Research Institute, Universidad de Santander (UDES), Bloque G, piso 6, Bucaramanga 680003, Colombia
Johanna Otero: Masira Research Institute, Universidad de Santander (UDES), Bloque G, piso 6, Bucaramanga 680003, Colombia
Claudia Torres: Masira Research Institute, Universidad de Santander (UDES), Bloque G, piso 6, Bucaramanga 680003, Colombia
Alvaro Castañeda-Hernandez: Masira Research Institute, Universidad de Santander (UDES), Bloque G, piso 6, Bucaramanga 680003, Colombia
Daniel Martinez-Bello: Masira Research Institute, Universidad de Santander (UDES), Bloque G, piso 6, Bucaramanga 680003, Colombia
Claudia Garcia: Masira Research Institute, Universidad de Santander (UDES), Bloque G, piso 6, Bucaramanga 680003, Colombia
Marianne Lopez-Cabrera: Masira Research Institute, Universidad de Santander (UDES), Bloque G, piso 6, Bucaramanga 680003, Colombia
Patricio Lopez-Jaramillo: Masira Research Institute, Universidad de Santander (UDES), Bloque G, piso 6, Bucaramanga 680003, Colombia

IJERPH, 2025, vol. 22, issue 8, 1-12

Abstract: Introduction: Low medication adherence and low hypertension control are a public health challenge, particularly in low- and middle-income countries (LMICs). Healthcare system- and patient-related barriers hinder the successful management of hypertension. This study aimed to identify the perceptions of barriers and facilitators to hypertension management among health system stakeholders in Santander, Colombia. Materials and Methods: We conducted a qualitative, phenomenological, and interpretative study, comprising five focus groups, to explore the barriers and facilitators to managing people with hypertension. Each focus group was formed by stakeholders from territorial entities, healthcare insurers, or healthcare providers. Meetings were held between December 2022 and February 2023. The sessions were recorded and transcribed using NVivo Transcription and analyzed using NVivo version 1.6.1. Results: Seven categories of barriers and facilitators were identified: strategies, resources, access, risk assessment, cross-sector collaboration, articulation, and stewardship. Of these categories, articulation and stewardship emerged as the main barriers, as revealed through axial coding and cluster analysis, which highlighted deficiencies in stewardship practices, a lack of clear objectives, and misalignment with public policy frameworks. Conclusions: Multisectoral actions extending beyond healthcare providers and aimed at improving coordination and intersectoral collaboration are essential for enhancing hypertension control in LMICs, such as Colombia. Addressing social determinants and strengthening primary healthcare through community-based strategies are critical, making stewardship and improved access key priorities.

Keywords: cardiovascular risk; hypertension; barriers; facilitators; community-based health programs; qualitative study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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