Effect of Self-Management Supporting Program on Medication Adherence and Blood Pressure Level Among the Older Patients with Uncontrolled Hypertension
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Abstract
This quasi-experimental research aimed to examine the effects of a self-management supporting program on medication adherence and blood pressure level among the older patients with uncontrolled hypertension by using the concept of 5 As’ model of self-management support consisting of: 1) assess 2) advise 3) agree 4) assist and 5) arrange for program development. The subjects were purposively selected and randomly allocated into control group and intervention group with 31 cases per group which were the older patients with uncontrolled hypertension, had systolic blood pressure ≥ 140 mmHg and/or with diastolic blood pressure ≥ 90 mmHg. In people with diabetes and/or chronic kidney disease or having systolic blood pressure ≥ 150 mmHg and/or having diastolic blood pressure ≥ 90 mmHg in people with hyperlipidemia. The control group received regular nursing care and the intervention group received regular nursing care with the self-management support program for 8 weeks. The results were used blood pressure level and medication adherence score by using the medication adherence questionnaire (Cronbach’s alpha coefficient 0.80). The personal information was analyzed using descriptive statistics and the hypotheses were tested using paired t-test and independent t-test.
The results showed that after completion of the program, the score of medication adherence in the intervention group (M = 49.1, SD = 1.19) was higher than before the implementation (M = 39.94, SD = 2.10) (t = -21.54, p < .001) and higher than the control group (M = 38.9, SD = 2.10) (t = -23.47, p < .001), while systolic blood pressure in the intervention group (M = 134.48, SD = 6.85) was lower than before the implementation (M = 164.35, SD = 10.08) (t =-18.80, p < .001) and lower than the control group (M = 167.87, SD = 11.59) (t = -13.81, p < .001), and diastolic blood pressure in the intervention group (M = 74.16, SD = 7.94) was lower than before the implementation (M = 83.74, SD = 9.92) (t = 8.82, p < .001), and lower than the control group (M = 86.10, SD = 9.52) (t = 5.36, p < .001).
The findings suggest the benefits of the self-management support program improve the medication adherence and better blood pressure control among the older patients with uncontrolled hypertension.
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References
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