s give for each correct response. Sum of scores of each item question is given as total score=38. These questions were first piloted on a 20 patients (outside the study center) before using them in the study. Questions regarding adherence and physician related factors were also asked however they are not reported here. Each questionnaire took 15–20 minutes for completion.
Blood pressure was recorded twice at the time of recruitment in the right arm using a mercury sphygmomanometer with the individual in the sitting position. Average of these blood pressure readings was taken as the blood pressure reading for categorization into controlled and uncontrolled hypertension. Data was then recorded by the research staff on demographics, details on history of hypertension and antihypertensive and comorbids on a data collection form specifically designed for this purpose. (Additional file1) Ethnicity was reported as ‘mother tongue’, which is specific for each of the five major ethnic subgroups of Pakistan: Urdu speaking, Punjabi, Sindhi, Pashtu, and Balochi. Formal education was categorized based on having no formal education, < 5 years, 6–10 years and > 10 years. A history of physician-diagnosed diabetes, stroke, ischemic heart disease (IHD), chronic kidney disease (CKD) as documented in the medical records was noted. Diabetes was defined as fasting plasma glucose ≥126 mg/dl at a prior visit. Stroke was defined clinically as an acute neurologic dysfunction of vascular origin with sudden(within seconds) or at least rapid (within hours)occurrence of symptoms and signs corresponding to the involvement of focal areas in the brain. Ischemic heart disease was diagnosed using WHO definition. Smokers were defined as individuals who reported current smoking and having smoked at least 100 cigarettes or ‘birdees’ during their lifetime.
The Research staff was trained for a week to fill these data collection form. However the data collection form was not validated. Confidentiality was maintained and each data collection form was assigned a code which was kept under lock and key. To compensate for the time spent in filling the form, each patient was given an information brochure on hypertension. Data was entered by two separate data entry operators on epiinfo.
Statistical package for social sciences version 17 was used for analysis. Mean and standard deviation was used for quantitative variable and frequency and percentage for qualitative variables. Knowledge is reported as frequency and percentage for individual correct response to each item question and composite total score; mean (SD). Data was also stratified on basis of control of hypertension. Uncontrolled hypertension was defined as average BP ≥140/90 mm Hg in no diabetic patients on treatment (for diabetic participants, hypertension will be considered to be uncontrolled if the average BP is ≥130/80 mm Hg). Controlled hypertension was defined as average BP <140/90 mm Hg in nondiabetic patients on treatment (for diabetic participants, hypertension will be considered to be uncontrolled if the average BP is <130/80 mm Hg). Student’s t test was used to compare quantitative variable and chi square test to compare categorical variable. Linear regressions were used to determine association of knowledge score with candidate variables. Multiple linear regressions were used to determine the association of all these variables in one model. Dummy variables were made for variables of ethnicity and level of education as they had more than two categories. All variable which were clinically important variables, or those that were associated with the outcomes at P < 0.2 in the univariate analysis were run in the final model. Final model was adjusted for age and duration of hypertension.
A total of 650 participants were approached; 350 in AKU, 150 in DUHS and 150 in ZMU.Of the total participants who were approached and who consented, 447 were found eligible%(n); 63.5(284) from Aga Khan University, 22.6(101) from Dow University of health sciences and 13.9(62) from Ziauddin University. Overall response ra