Effects of a Health Belief Promotion Program through the Line Application on Medication Use Behaviors and Blood Pressure Levels Among Patients with Post-Hypertensive Urgency
Keywords:
Health belief promotion program, Hypertensive urgency, LINE application, Medication use behaviorsAbstract
Hypertensive urgency is a common clinical emergency among patients with hypertension due to uncontrolled blood pressure. This experimental research aimed to study the effects of a health belief promotion program, delivered through the LINE application, on medication use behaviors and blood pressure levels among patients with post-hypertensive urgency. The participants consisted of 48 patients with post-hypertensive urgency. Participants were selected using simple random sampling and randomly assigned to either the experimental or control groups, with 24 participants in each group. The experimental group received usual nursing care in combination with the medication use behavior promotion program based on the health belief model framework developed by Rosenstock. The program involved (1) enhancing individual health beliefs by providing educational infographics delivered through the LINE application; and (2) promoting cues to action by sending medication reminder messages, assessing barriers to medication use through the LINE application, and conducting follow-up telephone calls. The intervention lasted four weeks. The control group received only routine care. Data were collected using a demographic questionnaire and a medication use behaviors questionnaire and were analyzed using descriptive statistics, independent t-test, and paired t-test.
The findings revealed that the experimental group who received the health belief promotion program through the LINE application for four weeks had mean medication use behavior scores that were significantly higher than those before the intervention (t = 12.62, p < .05) and significantly higher than those of the control group (t = -5.52, p < .05). The experimental group also had mean systolic blood pressure and mean diastolic blood pressure levels that were significantly lower than those before the intervention (t = -11.61, p < .05; t = -6.24, p < .05) and significantly lower than those of the control group (t = 2.53, p < .05; t = 1.85, p < .05).
The findings of this study indicate that the health belief promotion program through the LINE application improves medication use behaviors and reduces blood pressure levels. Therefore, healthcare teams should consider implementing this program among patients with post-hypertensive urgency to promote appropriate medication use.
References
Al-Hazmi, A. H., Alanazi, A. D. M., Thirunavukkarasu, A., Alriwely, N. S., Alrais, M. M. F., Alruwaili, A. B. S., Alnosairi, M. S., & Alsirhani, A. I. (2025). Evaluation of hypertension knowledge and its association with medication adherence among hypertensive patients attending primary health centers: A cross-sectional study from eastern Saudi Arabia. Frontiers in Public Health, 12, 1378561. https://doi.org/10.3389/fpubh.2024.1378561
Alley, W. D., & Copelin II, E. L. (2023). Hypertensive urgency. StatPearls.
Boonsin, C., Poum, A., & Makmai, P. (2021). Drug used behavior among elderly patients with hypertension in Phetchabun Province. Science and Technology Northern Journal, 2(2), 16-28. https://he03.tci-thaijo.org/index.php/scintc/article/view/1125/891 (in Thai)
Brust, M., Gebhardt, W. A., Ter Hoeve, N., Numans, M. E., & Kiefte-de Jong, J. C. (2024). Exploring timing and delivery of lifestyle advice following an acute cardiac event hospitalization: The cardiac patient’s perspective. Patient Education and Counseling, 124, 108279. https://doi.org/10.1016/j.pec.2024.108279
Bucci, T., Argyris, A., Alsomali, A., Lam, S. H. O., Gerra, L., Proietti, R., Beevers, G. D., Shantsila, E., Shantsila, A., & Lip, G. Y. H. (2024). One-year risk of all-cause death and major cardiovascular events in patients presenting with hypertensive crisis: A report from a global federated research health network. European Heart Journal, 45(Suppl_1), ehae666.2547. https://doi.org/10.1093/eurheartj/ehae666.2547
Bureenork, O., & Buatee, S. (2025). The relationship between health literacy and medication adherence behaviors among older adults with hypertensive urgency. The Southern College Network Journal of Nursing and Public Health, 12(3), e274562. https://he01.tci-thaijo.org/index.php/scnet/article/view/274562/187861 (in Thai)
Charoenwongsa, K., Wirojratana, V., & Wattanakitkrileart, D. (2022). The effect of a medication adherence promotion program through the LINE application on older persons with essential hypertension. Nursing Journal CMU, 49(2), 313-325. (in Thai)
Cherfan, M., Vallée, A., Kab, S., Salameh, P., Goldberg, M., Zins, M., & Blacher, J. (2020). Unhealthy behaviors and risk of uncontrolled hypertension among treated individuals: The constances population-based study. Scientific Reports, 10(1), 1925. https://doi.org/10.1038/s41598-020-58685-1
Committee for the Development of Screening and Health Assessment Tools for Older Persons. (2021). Manual for screening and health assessment of older persons 2021. Ministry of Public Health. https://shorturl.asia/swMKF
Fragoulis, C., Lazarou, E., & Tsioufis, K. (2021). Hypertensive emergencies: Still an emergency? Journal of Hypertension Research, 7(4), 119–123. https://hypertens.org/images/202112/jhr-202112-070401.pdf
Kotruchin, P., Pratoomrat, W., Mitsungnern, T., Khamsai, S., & Imoun, S. (2021). Clinical treatment outcomes of hypertensive emergency patients: Results from the hypertension registry program in Northeastern Thailand. The Journal of Clinical Hypertension, 23(3), 621–627. https://doi.org/10.1111/jch.14119
Krämer, B. K., Krämer, R. M., Benck, U., & Krüger, B. (2019). Nonadherence in patients with hypertensive emergency or hypertensive urgency. The Journal of Clinical Hypertension, 21(1), 64–66. https://doi.org/10.1111/jch.13442
Kumpiriyapong, N., & Sasat, S. (2017). The effect of health belief programme on medicine used behavior in older persons with hypertension. Royal Thai Navy Medical Journal, 44(3), 67-83. (in Thai)
Overgaauw, N., Alsma, J., Brink, A., Hameli, E., Bahmany, S., Peeters, L. E. J., van den Meiracker, A. H., Schuit, S. C. E., Koch, B. C. P., & Versmissen, J. (2019). Drug nonadherence is a common but often overlooked cause of hypertensive urgency and emergency at the emergency department. Journal of Hypertension, 37(5), 1048–1057. https://doi.org/10.1097/HJH.0000000000002005
Piamsukwilai, P., Ua-kit, N., & Anuruang, S. (2024). The effect of belief modification of reducing sodium consumption on blood pressure level among persons with uncontrolled hypertension. Thai Journal of Cardio-Thoracic Nursing, 35(2), 17-32. (in Thai)
Promrat, S., Kapol, P., & Kapol, N. (2022). Effects of a program to promote medication adherence using telepharmacy in patients with hypertension. Thai Bulletin of Pharmaceutical Sciences, 17(1), 31–41. (in Thai)
Reamrimmadun, Y., & Sombutputhon, P. (2018). Factors related to drug compliance behaviors of hypertension patients in the community, Ban Pho District, Chachoengsao Province. Nursing Public Health and Education Journal, 19(1), 132-144. https://he01.tci-thaijo.org/index.php/bcnpy/article/view/104794/135355 (in Thai)
Rosenstock, I. M. (1974). The health belief model and preventive health behavior. Health Education Monographs, 2(4), 354–386. https://doi.org/10.1177/109019817400200405
Ruksakulpiwat, S., Schiltz, N. K., Irani, E., Josephson, R. A., Adams, J., & Still, C. H. (2024). Medication adherence of older adults with hypertension: A systematic review. Patient Preference and Adherence, 18, 957–975. https://doi.org/10.2147/PPA.S459678
Seidu, S., Hambling, C. E., Kunutsor, S. K., & Topsever, P. (2023). Associations of blood pressure with cardiovascular and mortality outcomes in over 2 million older persons with or without diabetes mellitus: A systematic review and meta-analysis of 45 cohort studies. Primary Care Diabetes, 17(6), 554-567. https://doi.org/10.1016/j.pcd.2023.09.007
Siddiqi, T. J., Usman, M. S., Rashid, A. M., Javaid, S. S., Ahmed, A., Clark, D., III, Flack, J. M., Shimbo, D., Choi, E., Jones, D. W., & Hall, M. E. (2023). Clinical outcomes in hypertensive emergency: A systematic review and meta-analysis. Journal of the American Heart Association, 12(14), e029355. https://doi.org/10.1161/JAHA.122.029355
Thai Hypertension Society. (2019). 2019 Thai guidelines on the treatment of hypertension. Trick Think. (in Thai)
Tomduangkaew, P., Opasanant, P., & Hinmal, K. (2024). Factors affecting blood pressure level control in patients with hypertension. Journal of Nursing and Public Health Research, 4(2), e268403. https://he02.tci-thaijo.org/index.php/jnphr/article/view/268403/184386 (in Thai)
Wattanaburapakul, A., Leelacharas, S., & Jianvitayakij, S. (2021). Factors related to compliance to high blood pressure therapy among patients with hypertensive crisis. Chulalongkorn Medical Journal, 65(3), 311–317. https://doi.org/10.14456/clmj.2021.41
World Health Organization. (2025). Fact sheets: Hypertension. https://www.who.int/news-room/fact-sheets/detail/hypertension
Xu, H., & Long, H. (2020). The effect of smartphone app-based interventions for patients with hypertension: Systematic review and meta-analysis. JMIR mHealth and uHealth, 8(10), e21759. https://doi.org/10.2196/21759
Yazdanpanah, Y., Saleh Moghadam, A. R., Mazlom, S. R., Haji Ali Beigloo, R., & Mohajer, S. (2019). Effect of an educational program based on health belief model on medication adherence in elderly patients with hypertension. Evidence Based Care Journal, 9(1), 52-62.
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