EFFECTIVENESS OF PATIENT’S EDUCATION IN SELF-MANAGEMENT OF BLOOD PRESSURE IN HYPERTENSIVE PATIENTS

Main Article Content

Kiran Manzoor
Prof. Dr. Samina Kausar
Dr. Mansoor Ghani

Keywords

Patient Education, Self-Management, Blood Pressure, Hypertensive Patients, Effectiveness

Abstract

Introduction: Deregulated blood pressure becomes the most concerned issue in Pakistan, Asia and responsible for heart stroke, failures and other cardiovascular diseases. Normal blood pressure considers by clinicians worldwide is >120/80 mm Hg and any value between <130-140 mm Hg systolic and <80-90 mm Hg diastolic shows hypertension. To control blood pressure, medication and sometime invasive treatments are basic requirements, but by using non-pharmacological measures and changes in lifestyle gives great relief in hypertensive patients.  By educating hypertensive patients to adapt healthy lifestyle and eating habits alongwith taking medicines and regular visits to healthcare favors the reduction of blood pressure levels and contributes to the prevention of complications.


Materials and Methods: Randomized clinical trial was conducted at a tertiary care Cardiac Hospital, Lahore, Pakistan. About 150 hypertensive patients were enrolled in the study that are getting treatment and divided randomly into intervention and control groups. Pre-test post-test method was used to analyze self-knowledge and blood pressure changes.


Results: By educating intervention group participants, the knowledge level of participants was significantly improved showing post intervention values i.e., p=0.00. This resulted in significant control of blood pressure in the intervention group (i.e., p=0.00).


Conclusion: The importance of patient’s education is proved by imparting education regarding compliance of medication and adoption of non-pharmacological measures for better blood pressure control. Nurses should get engage in health education and awareness programs to meet the needs of the people for increased adherence to their medication and treatment regimens. Recommendations from this study will assist policy makers and healthcare professionals in developing relevant and context-specific policies that can improve hypertension management.

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References

1. AKOKO, B. M., FON, P. N., NGU, R. C. & NGU, K. B. 2017. Knowledge of Hypertension and Compliance with Therapy Among Hypertensive Patients in the
2. Bamenda Health District of Cameroon: A Cross-sectional Study. Cardiology and Therapy, 6, 53
3. ARTINIAN, N., GLEASON-COMSTOCK, J., STREATER, A. L., JEN, K. L., BAKER, S. & TIMMINS, J. 2012. Feasibility of a kiosk-based hypertension self-care education system in a primary care clinic for the uninsured. J Clin Hypertens, Supplement 14.
4. CHOBANIAN AV, BAKRIS GL, BLACK HR, 2011 National Heart, Lung, and Blood Institute Joint National Committee , The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC 7 report. JAMA 2011;289:2560-2572
5. HERTTUA, K., TABÁK, A. G., MARTIKAINEN, P., VAHTERA, J., & KIVIMÄKI, M. (2013). Adherence to antihypertensive therapy prior to the first presentation of stroke in hypertensive adults: Population-based study. European Heart Journal, 34(38), 2933– 2939. doi:10.1093/eurheartj/eht2
6. JINGI, A. M. & NOUBIAP, J. J. N. 2015. Cardiovascular risk factors awareness and prevalence among primary care physicians: an insight from the West region Awareness Initiative Survey to fight cardiovascular disease (WAIT-CVD) in Cameroon. BMC Research Notes, 8, 762.
7. KAUR, M. & CHEEMA, P. 2016. Effectiveness of planned teaching program on knowledge regarding early sign and symptoms of myocardial infarction among hypertensive patients. Heart India, 4, 123-128.
8. Afifah, R. N., Lubis, R., & Siagian, A. (2023). The Effect of Smoking Habits and Diet on Prehypertension Among Young Adults in Pekanbaru City. International Journal of Health, Education & Social (IJHES), 6(12), 53-66.
9. Akoko, B. M., Fon, P. N., Ngu, R. C., & Ngu, K. B. (2017). Knowledge of Hypertension and Compliance with Therapy Among Hypertensive Patients in the Bamenda Health District of Cameroon: A Cross-sectional Study. Cardiology and Therapy, 6(1), 53-67. https://doi.org/10.1007/s40119-016-0079-x
10. Aslam, N., Shoaib, M., Bushra, R., Farooqi, F., Zafar, F., Ali, H., & Saleem, S. (2018). Out of pocket (OOP) cost of treating hypertension in Karachi, Pakistan.
11. Baryakova, T. H., Pogostin, B. H., Langer, R., & McHugh, K. J. (2023). Overcoming barriers to patient adherence: the case for developing innovative drug delivery systems. Nature Reviews Drug Discovery, 22(5), 387-409.
12. Benowitz, N. L., & Liakoni, E. (2022). Tobacco use disorder and cardiovascular health. Addiction, 117(4), 1128-1138.
13. Bollampally, M., Chandershekhar, P., Kumar, K. P., Surakasula, A., Srikanth, S., & Reddy, T. R. M. (2017). Assessment of patient’s knowledge, attitude and practice regarding hypertension [Hypertension, KAP, Home medication review]. 2017, 4(8), 6. https://doi.org/10.18203/2320-6012.ijrms20162283
14. Carson, M. (2016). The Effective Management of High Blood Pressure by Improving Adherence Through Education.
15. Cicolini, G., Comparcini, D., & Simonetti, V. (2014). Workplace empowerment and nurses' job satisfaction: a systematic literature review. Journal of Nursing Management, 22(7), 855-871.
16. Elahi, A., Ali, A. A., Khan, A. H., Samad, Z., Shahab, H., Aziz, N., & Almas, A. (2023). Challenges of managing hypertension in Pakistan-a review. Clinical Hypertension, 29(1), 17.
17. Ernawati, I., Lubada, E. I., Lusiyani, R., & Prasetya, R. A. (2022). Association of adherence measured by self-reported pill count with achieved blood pressure level in hypertension patients: a cross-sectional study. Clinical Hypertension, 28(1), 12. Farsalinos, K., Cibella, F., Caponnetto, P., Campagna, D., Morjaria, J. B., Battaglia, E., Caruso, M., Russo, C., & Polosa, R. (2016). Effect of continuous smoking reduction and abstinence on blood pressure and heart rate in smokers switching to electronic cigarettes. Internal and Emergency Medicine, 11(1), 85-94.
18. Gleason-Comstock, J., Streater, A., Ager, J., Goodman, A., Brody, A., Kivell, L., Paranjpe, A., Vickers, J., Mango, L., Dawood, R., & Levy, P. (2015). Patient education and follow-up as an intervention for hypertensive patients discharged from an emergency department: a randomized control trial study protocol. BMC Emergency Medicine, 15, 38-38.
https://doi.org/10.1186/s12873-015-0052-3
19. Hamrahian, S. M., Maarouf, O. H., & Fülöp, T. (2022). A critical review of medication adherence in hypertension: barriers and facilitators clinicians should consider. Patient preference and adherence, 2749-2757.
20. Herath, P., Wimalasekera, S., Amarasekara, T., Fernando, M., & Turale, S. (2022). Effect of cigarette smoking on smoking biomarkers, blood pressure and blood lipid levels among Sri Lankan male smokers. Postgraduate medical journal, 98(1165), 848-854.
21. Kamran, A., Ahari, S. S., Biria, M., Malpour, A., & Heydari, H. (2014). Determinants of patient’s adherence to hypertension medications: application of health belief model among rural patients. Annals of medical and health sciences research, 4(6), 922-927.
22. Kamvura, T. T., Dambi, J. M., Chiriseri, E., Turner, J., Verhey, R., & Chibanda, D. (2022). Barriers to the provision of non-communicable disease care in Zimbabwe: a qualitative study of primary health care nurses. BMC nursing, 21(1), 64.
23. Lee, H. J., Jang, S.-I., & Park, E.-C. (2017). Effect of adherence to antihypertensive medication on stroke incidence in patients with hypertension: a population-based retrospective cohort study. BMJ Open, 7(6), e014486. https://doi.org/10.1136/bmjopen-2016-014486
24. Muntner, P., Miles, M. A., Jaeger, B. C., Hannon Iii, L., Hardy, S. T., Ostchega, Y., Wozniak, G., & Schwartz, J. E. (2022). Blood pressure control among US adults, 2009 to 2012 through 2017 to 2020. Hypertension, 79(9), 1971-1980.
25. Proia, K. K., Thota, A. B., Njie, G. J., Finnie, R. K., Hopkins, D. P., Mukhtar, Q., Pronk, N. P., Zeigler, D., Kottke, T. E., & Rask, K. J. (2014). Team-based care and improved blood pressure control: a community guide systematic review. American journal of preventive medicine, 47(1), 86-99.
26. Punna, S., & Kodudula, S. (2022). Adherence to antihypertensive medications and its determinants among adult hypertensive patients. Journal of Krishna Institute of Medical Sciences (JKIMSU), 11(4).
27. Riaz, M., Shah, G., Asif, M., Shah, A., Adhikari, K., & Abu-Shaheen, A. (2021). Factors associated with hypertension in Pakistan: A systematic review and meta-analysis. PloS one, 16(1), e0246085.
28. Saneei, P., Salehi-Abargouei, A., Esmaillzadeh, A., & Azadbakht, L. (2014). Influence of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure: A systematic review and meta-analysis on randomized controlled trials. Nutrition, Metabolism and Cardiovascular Diseases, 24(12), 1253-1261. https://doi.org/https://doi.org/10.1016/j.numecd.2014.06.008
29. Shah, N., Shah, Q., & Shah, A. J. (2018). The burden and high prevalence of hypertension in Pakistani adolescents: a meta-analysis of the published studies [journal article]. Archives of Public Health, 76(1), 20. https://doi.org/10.1186/s13690-018-0265-5
30. Siervo, M., Lara, J., Chowdhury, S., Ashor, A., Oggioni, C., & Mathers, J. C. (2014). Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis. British Journal of Nutrition, 113(1), 1-15. https://doi.org/10.1017/S0007114514003341
31. Villar, J. C., Vásquez, S. M., Balcázar, A. M., López, L. A. T., Barrera, E. C., & Moreno, A. M. (2023). Reporting of blood pressure levels and self-monitoring practices: a survey among outpatients diagnosed with hypertension in Bogotá, Colombia. BMC Primary Care, 24(1), 185.
32. WHO. (2013). Global action plan for the prevention and control of noncommunicable diseases 2013–2020. Follow-up to the political declaration of the high-level meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases,
33. Xu, L. J., Meng, Q., He, S. W., Yin, X. L., Tang, Z. L., Bo, H. Y., & Lan, X. Y. (2013). The effects of health education on patients with hypertension in China: A meta-analysis. Health Education Journal, 73(2), 137-149. https://doi.org/10.1177/0017896912471033