Effects of a Self-management Program on Medication Adherence and Blood Pressure Level Among Persons with Hypertension in a Community

Abstract

This study examined the effects of a self-management program on medication adherence scores and blood pressure levels among people with hypertension in a community. It was a two-group quasi-experimental study with a pretest-posttest design. The objectives of the study were to compare medication adherence scores and blood pressure levels of people in a community. The sample group consisted of 48 people with hypertension, aged 35 to 59 years, who were equally divided with 24 people each in the experimental group and control group. The study was conducted in Sri Bua Ban Subdistrict, Muang District, Lamphun Province. The experimental group received the self-management program for 8 weeks. The program was developed by the researcher by applying the self-management concept (Kanfer & Gaelick-Buys, 1991), and included 3 steps: 1) self-monitoring, 2) self-evaluation, and 3) self-reinforcement. The control group received standard care. Data were collected using a demographic questionnaire and a medication adherence scale (in Thai) with a CVI of .96 and a reliability coefficient value of .98. Data on medication adherence scores were analyzed using the paired sample t-test and t-test for the independent sample. Blood pressure levels were analyzed by the Wilcoxon Matched Pairs Signed-Ranks Test and the Mann-Whitney U Test.

The results revealed that the experimental group who received the self-management program for 8 weeks had average medication adherence scores which were higher than before receiving the self-management program with statistical significance (p < 0.05) and higher than the control group who received regular nursing care with statistical significance (p < 0.05). It was found that the experimental group had lower mean blood pressure levels than before receiving the self-management program with statistical significance (p < 0.05) and less than those of the control group, but there was no statistical significance (p > 0.05). After receiving the self-management program, the experimental group had a difference in mean change of blood pressure levels which was lower than the control group with statistical significance (p < 0.05).

The results of this research will be beneficial to community nurse practitioners and health care teams who can use them as guidelines for promoting self-management of people with hypertension in the community. Together with telephone follow-up and home visits, they can educate people to build an understanding of hypertension and how to take the right type of antihypertensive medications at the right dose and the right time, continuously and regularly, and be able to properly manage adverse drug reactions to effectively reduce blood pressure levels.