A qualitative study published in BMC Health Services Research has identified specific facilitators and barriers affecting the implementation of community-based medication adherence support for older adults living with HIV and hypertension in Western Kenya. As antiretroviral therapy has improved the longevity of people with HIV, the aging of this population has led to an increased prevalence of comorbidities such as hypertension, creating a dual burden of medication management that challenges current adherence strategies.

The study focused on the implementation of a patient-tailored community-based medication adherence support program, specifically one led by community health volunteers. The primary objective was to understand the factors that either support or hinder the delivery of these services to older adults with HIV who also manage hypertension. The data were organized using the Consolidated Framework for Implementation Research.

The methodology involved a qualitative design with 166 purposefully sampled participants across three health facilities in Western Kenya. The data collection process included in-depth interviews with 27 healthcare providers, 28 community health volunteers, and 25 caregivers of older adults. Additionally, six focus group discussions were conducted with 86 older adults with HIV who were affiliated with the participating facilities. These interactions covered topics related to the perceived barriers and facilitators of having a community health volunteer visit the homes of older adults to offer medication adherence support.

Several facilitators were identified that could positively influence the implementation of the intervention. Reported facilitators included enhanced collaboration between facility and community care providers. The intervention was also viewed as having the potential to promote patient-centered care.

However, the research also uncovered significant barriers that may impede the successful rollout of the program. Participants voiced several factors that may impede the intervention, such as its complexity. Participants also noted increased workload and costs for community health volunteers. Limited knowledge of hypertension management was also voiced as an impediment to the intervention. Unmet patient needs and limited health financing for non-communicable disease medications were also cited as critical systemic issues that need to be addressed.

Fears of decreased cognitive ability, low perception of cardiovascular risk, and concerns about medication side effects were identified as factors that could undermine the effectiveness of the support program. Trust and empathy between community health volunteers and patients were identified as critical personal attributes that foster patient empowerment.

The findings underscore the necessity for a holistic, multidimensional approach to addressing medication adherence in this population. The findings underscore the necessity for addressing medication adherence by providing older adults with HIV with requisite hypertension management messaging. The authors also highlight the need to revisit health system barriers, specifically non-communicable disease care financing. The research also calls for facilitating community health volunteers with the necessary knowledge, skills, and remuneration to enable them to efficiently support the community-based adherence intervention.

Subject of Research: Implementation of community-based medication adherence support for aging individuals with HIV and hypertension in Western Kenya

Article Title: Facilitators and barriers to the implementation of community-based medication adherence support for aging individuals with HIV and hypertension in Western Kenya

Article References: Kiplagat, J., Naanyu, V., Nehema, R., Zakumumpa, H., & Wools-Kaloustian, K. (2026). Facilitators and barriers to the implementation of community-based medication adherence support for aging individuals with HIV and hypertension in Western Kenya. BMC Health Services Research. https://doi.org/10.1186/s12913-026-16134-1

Image Credits: AI Generated

DOI: 10.1186/s12913-026-16134-1

Keywords: HIV, hypertension, medication adherence, community health volunteers, Western Kenya, aging population, qualitative research, implementation science, chronic disease management, patient-centered care, health system barriers, non-communicable diseases, antiretroviral therapy, caregiver support, health financing, cardiovascular risk, medication side effects, trust and empathy, healthcare providers, focus group discussions