Patients' perceptions of hypertension management: a concern for healthcare practitioners.

691 evaluation of non-adherence in chronic disease management and in patients with hypertension in particular. However, there is a paucity of data in the context of hypertensive patients’ perspective from developing countries, to gather in-depth information towards hypertension management. In the context of developing nations like Pakistan, health-seeking behaviour always occurs in the context of medical pluralism, where the patient uses different systems of healing. Patients make independent assessments regarding the use of modern medicines. Orthodox medications do not have such dominance over the population as seen in the western world. In addition, indigenous healing systems, particularly hikmat (treatment with herbs) and spiritual healing, are quite prominent in these populations. There is no legal or official acknowledgment as far as the spiritual healing is concerned; but it is still the treatment of choice for the majority of the population. Insufficient information and understanding emerges as major barriers associated with all aspects of medicine use. Knowledge about the disease and drugs used for its treatment is apparently poor and in return produces a great impact on patients’ adherence to medication. Another issue that lies ahead for health practitioners is that discussions of the advantages and disadvantages of drugs in ways that are relevant for individual patients is rarely seen in practice. What is needed at this point is a complete revision of the practices that are currently being employed in the healthcare system. Individuals must be educated not only on the risk factors, presenting features, and complications of hypertension, but also about the benefits of medications on treatment outcomes and quality of life. Patients may need to be educated about the differences between curing hypertension and treating it with medications. Efforts to educate the public about lifestyle modifications in the prevention of hypertension and other cardiovascular diseases may also be of great importance. Advancement in are stopped suddenly, including during anaesthesia. The steroid treatment card acts as a reminder to patients about the potential side effects and dangers of abrupt cessation, as well as a warning to healthcare professionals about patients’ medication status: ultimately it aims to ensure patient safety. This audit demonstrated that the British National Formulary guidelines are not being met in 2010: almost 50% of patients did not have a steroid treatment card and of those with a card, few always carried it. These findings reflect those of Zeppetella’s survey, suggesting that this may be a long-standing, widespread problem. Steroid treatment cards should be distributed to and carried by patients on long-term steroids: this issue needs to be recognised and steps taken to improve clinical practice in this area.