The effect of patient education and home monitoring on medication compliance, hypertension management, healthy lifestyle behaviours and BMI in a primary health care setting

Aim: The aim of this study was to determine the effect of anti-hypertensive patient-oriented education and in-home monitoring for medication adherence and management of hypertension in a primary care setting, by providing education on healthy lifestyle behaviours and medication adherence.

Background: Hypertension is the third most common cause of death worldwide. Prevalence of hypertension in Turkey is approximately 30% in the general population and 45-50% in population over 50.

Design: Randomised controlled study.

Methods: This study conducted in Turkey used a study group comprised of 120 subjects (40 Group A, 40 Group B, 40 controls), all previously diagnosed with hypertension and who started medication therapy at least one year prior to start of study. The study was conducted between February-November 2006 at public primary health care facilities and homes of the study participants. Participants in Group A and B received a total of six monthly education sessions, four times during clinic visits and two home visits. Medication adherence education for Groups A and B and education about healthy lifestyle behaviours for Group B were administered in a structured and individualised format. The control group was routinely monitored in health care facilities.

Results: Healthy lifestyle behaviours and perception of self-efficacy regarding medication adherence showed improvement after education sessions in Groups A and B. Systolic and diastolic blood pressures of subjects in Group A and B showed a significant decrease compared with those of the control group; the blood pressure decrease in Group B was greater than in Group A.

Conclusion: Nurses play an important role in uncontrolled hypertension detection and can improve medication adherence and healthy lifestyle behaviours.

Relevance to clinical practice: Patient education medication adherence alone and in combination with healthy lifestyle behaviour teaching is an effective tool for blood pressure reduction in the hypertensive population in primary health care settings.