Assessment of effectiveness of an interventional package on treatment adherence of hypertensive patients: a randomized control trial

Authors

  • Kmendalin Nongspung Department of Community Health, PGIMER, Chandigarh, India http://orcid.org/0000-0002-7296-754X
  • Kavita Narang Department of Community Health, PGIMER, Chandigarh, India
  • Jarnail Singh Thakur Department of Community Health, PGIMER, Chandigarh, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20211986

Keywords:

Treatment adherence, Hypertension, Cluster randomised control trial, Interventional package

Abstract

Background: Hypertension is the most common non-communicable diseases. Strict adherence to prescribed antihypertensive treatments is the key to blood pressure control. The present study was conducted with the objective to develop, implement and assess an interventional package on treatment adherence for hypertensive patients.

Methods: A clustered randomized control trial of 3 months conducted in two community sites of Chandigarh. The two sites were first randomized by lottery method as experimental and control sites. Total of 250 subjects (n=125 on each sites) were selected by a systematic random sampling technique (every fourth) from the sampling frame. Diagnosed hypertensive patients taking treatment were included in the study and females with pregnancy induced hypertension were excluded. Participants were interviewed as per Interview schedule. Data was collected from July to November 2018. Interventional package was in the form of booklet and flash card, delivered as one to one teachings. Total of 5 face to face follow ups were done to the experimental group. Control group received routine care. Final evaluation was done at 3rd month in both the groups to assess the effectiveness of an interventional package on treatment adherence. Data analysis and interpretation was done by using chi square, paired t test, unpaired t- test, Mc Nemar test were applied to determine the level of significance at p<0.05.

Results: The proportion of subjects who were adhered to the treatment has increased from 16% to 68% in the experimental group at third month of follow up. The mean change in systolic blood pressure and diastolic blood pressure were 26.29±12.81 mmHg and 7.74±8.95 mmHg respectively in the experimental group as compared to the control group (p<0.05).

Conclusions: The interventional package on treatment adherence among hypertensive patients was effective in improving the treatment adherence.

References

World health statistics 2018: monitoring health for the SDGs. Available at: http://apps.who.int/en. Accessed on 20 January2021.

Noncommunicable Diseases Country profiles 2018. Available at: http://www.who.int/nmh/countries/en/. Accessed on 20 January2021.

Geldsetzer P, Manne-Goehler J, Theilmann M, Davies JI, Awasthi A, Vollmer S, et al. Diabetes and Hypertension in India: A Nationally Representative Study of 1.3 Million Adults. JAMA Intern Med. 2018;178(3):363-72.

Assessment of burden of non-communicable diseases in India. Available at: http://www.whoindia.org/ LinkFiles/Assessment_of_Burden_of_NCD_Hypertension_Assessment_of_Burden_of_NCDs.pdf. Accessed on 20 January2021.

Appel LJ, Champagne CM, Harsha DW, Cooper LS, Obarzanek E, Elmer PJ, et al. Effects of comprehensive lifestyle modification on blood pressure control: Main results of the PREMIER clinical trial. JAMA. 2003;289:2083-93.

Schwarz S, Halle M. Blood pressure lowering through physical training-what can be achieved?. MMW Fortschr Med. 2006;148:29-32.

Hagberg JM, Park JJ, Brown MD. The role of exercise training in the treatment of hypertension: An update. Sports Med. 2000;30:193-206.

Abegaz TM, Shehab A, Gebreyohannes EA, Bhagavathula AS, Elnour AA. Nonadherence to antihypertensive drugs. Medicine. 2017;96(4):85-9.

A global brief on hypertension. Available at: http://www. who.int/ nmh/publications /ncd_report _full_en.pdf). Accessed on 20 January2021.

Ndanuko RN, Tapsell LC, Charlton KE, Neale EP, Batterham MJ. Dietary patterns and blood pressure in adults: a systematic review and meta-analysis of randomized controlled trials. Adv Nutr. 2016;7(1): 76-89.

Vrijens B, De Geest S, Hughes DA, Przemyslaw K, Demonceau J, Ruppar T, et al. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012;73(5):691-705.

Weltermann B, Viehmann A, Kersting C. Hypertension management in primary care: study protocol for a cluster randomized controlled trial. Trials. 2015;16(1):105.

de Souza AC, Moreira TM, Oliveira ES, Menezes AV, Loureiro AM, Silva CB, et al. Effectiveness of Educational Technology in Promoting Quality of Life and Treatment Adherence in Hypertensive People. PLoS One. 2016;11(11):e0165311.

Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Interventions used to improve control of blood pressure in patients with hypertension. In: Cochrane database of systematic reviews. United States: John Wiley & Sons Ltd; 2010.

Costa E, Giardini A, Savin M, Menditto E, Lehane E, Laosa O, et al. Interventional tools to improve medication adherence: review of literature. Patient Prefer Adherence. 2015;9:1303-14.

Tjønna AE, Leinan IM, Bartnes AT, Jenssen BM, Gibala MJ, Winett RA, et al. Low and high volume of intensive endurance training significantly improves maximal oxygen uptake after 10-weeks of training in healthy men. PLoS ONE. 2013;8(5):80-7.

Saptharishi L, Soudarssanane M, Thiruselvakumar D, NavasakthiD, Mathanraj S, Karthigeyan M, et al. Community-based randomized controlled trial of non-pharmacological interventions in prevention and control of hypertension among young adults. Indian J Community Med. 2009;34:329-34.

Ndanuko RN, Tapsell LC, Charlton KE, Neale EP, Batterham MJ. Dietary patterns and blood pressure in adults: a systematic review and meta-analysis of randomized controlled trials. Adv Nutr. 2016;7(1): 76-89.

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Published

2021-05-25

How to Cite

Nongspung, K., Narang, K., & Thakur, J. S. (2021). Assessment of effectiveness of an interventional package on treatment adherence of hypertensive patients: a randomized control trial. International Journal Of Community Medicine And Public Health, 8(6), 2862–2868. https://doi.org/10.18203/2394-6040.ijcmph20211986

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Original Research Articles