Limits...
Use of family member-based supervision in the management of patients with hypertension in rural China.

Huang S, Chen Y, Zhou J, Wang J - Patient Prefer Adherence (2014)

Bottom Line: Findings from indepth interviews demonstrated that the limited effects of traditional health education, a lack of professional advice regarding antihypertensive treatment, and age were related to a patient's adherence with regular blood pressure measurement and taking medication.The patients preferred their spouse or a child as the supervisor.After the 6-month intervention, the proportion of patients with uncontrolled blood pressure decreased from 87.2% to 45.7%.

View Article: PubMed Central - PubMed

Affiliation: Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China ; Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China.

ABSTRACT
Medication nonadherence is a major problem in the management of hypertension. The aim of this study was to develop a family member-based supportive therapy for patients with hypertension to provide an affordable way to access essential health services and to ensure adequate control of blood pressure. This study applied a mixed methods approach using qualitative and quantitative study designs in Yangzhong County, a rural area in the People's Republic of China. Findings from indepth interviews demonstrated that the limited effects of traditional health education, a lack of professional advice regarding antihypertensive treatment, and age were related to a patient's adherence with regular blood pressure measurement and taking medication. We also performed a quantitative study, selecting two villages in Yangzhong County as study sites. A total of 188 patients with hypertension were invited to participate in a 6-month family member-based intervention trial. The primary outcomes were the acceptability and feasibility of the intervention strategy. Secondary outcomes included medication adherence and changes in blood pressure. More than 75% of patients expressed a wish for external reminders, and 93.5% responded that they would accept the family member-based supervision. The patients preferred their spouse or a child as the supervisor. After the 6-month intervention, the proportion of patients with uncontrolled blood pressure decreased from 87.2% to 45.7%. This pilot study shows that external supervision by family members is acceptable and feasible for patients with hypertension; it also shows favorable effects with regard to improved treatment adherence and blood pressure control. Future randomized controlled trials with modified intervention measures are needed to validate this finding.

No MeSH data available.


Related in: MedlinePlus

Flow chart of the trial.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4125371&req=5

f1-ppa-8-1035: Flow chart of the trial.

Mentions: This study applied a mixed methods approach using a qualitative and quantitative design. We purposely selected Yangzhong County as the study area. Yangzhong is an island located in the middle of the Yangtze River in the southeastern part of Jiangsu Province, People’s Republic of China, and has a population of 0.3 million and an area of 332 km2. We randomly selected two villages from Baqiao Town in Yangzhong County as the study sites. Using the local disease surveillance system, we recruited 210 patients with hypertension. The inclusion criteria were: essential hypertension; willingness to participate in this study; absence of hypertension-related complications; and residence with family members. After preliminary examination, we excluded 22 patients who did not meet the inclusion criteria (n=8), declined to participate (n=10), or could not be interviewed for other reasons (n=4). Finally, 188 patients with essential hypertension were recruited as the study subjects in February 2012. Face-to-face interviews were performed in the village conference room using a structured questionnaire. We recorded each patient’s basic demographic characteristics, socioeconomic status, treatment history, adherence with antihypertensive medication, and attitudes toward family member-based supervision. The patient’s BP was measured in mmHg using a mercury sphygmomanometer and was recorded in the form of two numbers, ie, systolic BP and diastolic BP. After the baseline investigation, we performed a 6-month self-controlled intervention trial. The intervention included the following elements: patients selected a family member as the observer to supervise their treatment; family observers were trained regularly; family observers supervised the patients taking their drugs and recorded their adherence; and observers were responsible for reminding patients to seek timely health care and to get their BP monitored on a regular basis. Face-to-face interviews were performed again at the end of the pilot study stage (September 2012) to collect outcomes, including medication adherence, changes in systolic and diastolic BP, and the percentage of patients with adequately controlled BP. A flowchart of the trial is shown in Figure 1.


Use of family member-based supervision in the management of patients with hypertension in rural China.

Huang S, Chen Y, Zhou J, Wang J - Patient Prefer Adherence (2014)

Flow chart of the trial.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4125371&req=5

f1-ppa-8-1035: Flow chart of the trial.
Mentions: This study applied a mixed methods approach using a qualitative and quantitative design. We purposely selected Yangzhong County as the study area. Yangzhong is an island located in the middle of the Yangtze River in the southeastern part of Jiangsu Province, People’s Republic of China, and has a population of 0.3 million and an area of 332 km2. We randomly selected two villages from Baqiao Town in Yangzhong County as the study sites. Using the local disease surveillance system, we recruited 210 patients with hypertension. The inclusion criteria were: essential hypertension; willingness to participate in this study; absence of hypertension-related complications; and residence with family members. After preliminary examination, we excluded 22 patients who did not meet the inclusion criteria (n=8), declined to participate (n=10), or could not be interviewed for other reasons (n=4). Finally, 188 patients with essential hypertension were recruited as the study subjects in February 2012. Face-to-face interviews were performed in the village conference room using a structured questionnaire. We recorded each patient’s basic demographic characteristics, socioeconomic status, treatment history, adherence with antihypertensive medication, and attitudes toward family member-based supervision. The patient’s BP was measured in mmHg using a mercury sphygmomanometer and was recorded in the form of two numbers, ie, systolic BP and diastolic BP. After the baseline investigation, we performed a 6-month self-controlled intervention trial. The intervention included the following elements: patients selected a family member as the observer to supervise their treatment; family observers were trained regularly; family observers supervised the patients taking their drugs and recorded their adherence; and observers were responsible for reminding patients to seek timely health care and to get their BP monitored on a regular basis. Face-to-face interviews were performed again at the end of the pilot study stage (September 2012) to collect outcomes, including medication adherence, changes in systolic and diastolic BP, and the percentage of patients with adequately controlled BP. A flowchart of the trial is shown in Figure 1.

Bottom Line: Findings from indepth interviews demonstrated that the limited effects of traditional health education, a lack of professional advice regarding antihypertensive treatment, and age were related to a patient's adherence with regular blood pressure measurement and taking medication.The patients preferred their spouse or a child as the supervisor.After the 6-month intervention, the proportion of patients with uncontrolled blood pressure decreased from 87.2% to 45.7%.

View Article: PubMed Central - PubMed

Affiliation: Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China ; Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China.

ABSTRACT
Medication nonadherence is a major problem in the management of hypertension. The aim of this study was to develop a family member-based supportive therapy for patients with hypertension to provide an affordable way to access essential health services and to ensure adequate control of blood pressure. This study applied a mixed methods approach using qualitative and quantitative study designs in Yangzhong County, a rural area in the People's Republic of China. Findings from indepth interviews demonstrated that the limited effects of traditional health education, a lack of professional advice regarding antihypertensive treatment, and age were related to a patient's adherence with regular blood pressure measurement and taking medication. We also performed a quantitative study, selecting two villages in Yangzhong County as study sites. A total of 188 patients with hypertension were invited to participate in a 6-month family member-based intervention trial. The primary outcomes were the acceptability and feasibility of the intervention strategy. Secondary outcomes included medication adherence and changes in blood pressure. More than 75% of patients expressed a wish for external reminders, and 93.5% responded that they would accept the family member-based supervision. The patients preferred their spouse or a child as the supervisor. After the 6-month intervention, the proportion of patients with uncontrolled blood pressure decreased from 87.2% to 45.7%. This pilot study shows that external supervision by family members is acceptable and feasible for patients with hypertension; it also shows favorable effects with regard to improved treatment adherence and blood pressure control. Future randomized controlled trials with modified intervention measures are needed to validate this finding.

No MeSH data available.


Related in: MedlinePlus