Study facility characteristics.

Fixed-dose combinations (FDCs) – 2-3 anti-hypertensive medications in a single pill - have the potential to improve hypertension treatment and outcomes. Yet, they are not widely implemented. Factors undermining implementation remain unknown, particularly in sub–Saharan Africa, where hypertension is a major cause of disease burden and is poorly controlled. This study explored the acceptability of FDCs among patients, caregivers, and healthcare workers. We conducted semi-structured in-depth interviews with 58 participants from four purposively selected health facilities in Kiambu county, Kenya. Data were analyzed using an iterative thematic analysis approach, guided by the Theoretical Framework of Acceptability. Our findings indicate that FDCs are potentially acceptable to all participant groups. Acceptability is supported by the perception of FDCs as a means of reducing treatment burden (for patients and healthcare workers) and improving treatment adherence, and by patients’ deferral to and trust in healthcare workers. However, acceptability among healthcare workers may be undermined by variable levels of knowledge about FDCs, concerns about FDCs as an “inflexible” treatment that does not allow dose titration or identifying causes of side effects, and concerns about inconsistent availability and affordability of FDCs in Kenya. To enhance acceptability and implementation of FDCs for hypertension treatment in Kenya, it is crucial to strengthen the capacity of all healthcare worker cadres to appropriately prescribe, inform patients about, and support adherence to FDCs. These efforts must align with broader initiatives to address upstream health system factors such as poor availability and affordability.Fixed-dose combinations (FDCs)——即单剂复方制剂包含2~3种抗高血压药物——具备改善高血压治疗效果与临床转归的潜力。然而此类制剂尚未得到广泛推广应用，其制约因素尚不明确，尤其在撒哈拉以南非洲地区：该区域高血压是疾病负担的主要诱因之一，且血压控制情况普遍欠佳。本研究针对患者、照护者及医护人员群体，探索固定剂量复方制剂（FDCs）的接受度现状。研究团队在肯尼亚基安布县4家经目的性遴选的医疗机构中招募58名参与者，开展半结构化深度访谈，并采用基于接受度理论框架的迭代式主题分析法对采集的数据进行分析。研究结果显示，所有参与群体对固定剂量复方制剂均具备潜在接受度。提升接受度的驱动因素包括：参与者认为该类制剂可减轻患者与医护人员的治疗负担、提高治疗依从性，以及患者对医护人员的依从与信任。但医护人员群体的接受度可能受多方面因素削弱：一是对固定剂量复方制剂的认知水平参差不齐；二是担忧该制剂"缺乏灵活性"——无法进行剂量滴定或排查不良反应的诱因；三是顾虑肯尼亚境内固定剂量复方制剂的供应稳定性与可及性不足。为提升肯尼亚高血压治疗中固定剂量复方制剂的接受度与推广落地，亟需全面强化各级医护人员的专业能力，使其能够合理开具固定剂量复方制剂、向患者做好相关健康宣教，并协助患者提升用药依从性。此类举措需与解决上游卫生系统结构性问题的整体规划相协同，例如改善药物供应不足与可及性欠佳的现状。