Development of A Home Blood Pressure Monitoring-Based Self-Management Model in Patients with Hypertension and Uncontrolled Blood Pressure

Abstract

Introduction Uncontrolled hypertension can result in severe complications, disabilities, and even death. Promoting patients to engage in self-management combined with home blood pressure monitoring is an approach to maintaining continuous control of their blood pressure. 

Objective To develop and investigate the effects of a home blood pressure monitoring based self-management model in patients with hypertension and uncontrolled blood pressure. 

Design This study is a Research and Development. 

Methods The researchers developed a home blood pressure monitoring based self-management model for patients with uncontrolled blood pressure at a community hospital in a province of central region, Thailand. The development process was divided into four phases: 1) Problem analysis phase, examining issues with traditional care approaches; 2) Development phase, developing a self-management model integrated with home blood pressure monitoring; 3) Implementation phase, applying the developed model in patient care and evaluating outcomes; and 4) Adjustment phase, refining the self-management model and home blood pressure monitoring. Data were collected from December 2020 to December 2021, and were then analyzed using Paired t test. 

Results The home blood pressure monitoring based self-management model included providing knowledge on hypertension, promoting appropriate practices on medication taking, food consumption, physical activity, and use of blood pressure monitoring tools including precise techniques for measuring blood pressure at home. A nurse conducted phone follow-ups in weeks 1, 2, and 4, with assessments scheduled in week 6 following the implementation of the model. Results revealed that patients’ medication taking behavior (M = 3.205, SD = 0.701) was significantly higher compared to the baseline (M = 2.562, SD = 2.144, t = -6.411, p < .001). Additionally, both systolic (M = 123.842, SD = 14.048) and diastolic (M = 76.122, SD = 12.206) blood pressure levels were significantly lower compared to the baseline (M = 135.303, SD = 11.037, t = 3.000 p = .045 and M = 85.221, SD = 9.903, t =4.864, p = .030, respectively). However, food consumption behavior (M = 11.312, SD = 0.890) and physical activity (M = 1.731, SD = 0.710) were not significantly different from the baseline (M = 11.153, SD = 0.839, t = -0.400, p > .05 and M = 1.710, SD = 0.756, t = 1.682, p > .05, respectively). 

Recommendation The home blood pressure monitoring based self-management model helps enhance knowledge and self-management skills in the patients. This can serve as a model for care and monitoring of patients with uncontrolled hypertension, enabling them to effectively control their blood pressure. It involves designing home blood pressure monitoring tailored to individual needs.