Comparison of Effects of Interactive Health Education and Self-Reading Learning on Blood Pressure Control in Hypertensive Patients: A Non-Randomised Controlled Trial

Rangla James; Shantibala Konjengbam; Soubam Christina

doi:10.55489/njcm.150220243452

Authors

Rangla James Regional Institute of Medical Sciences, Imphal, India
Shantibala Konjengbam Regional Institute of Medical Sciences, Imphal, India
Soubam Christina Regional Institute of Medical Sciences, Imphal, India

DOI:

https://doi.org/10.55489/njcm.150220243452

Keywords:

Health education, Hypertension, Non-Randomised Controlled Trial, Knowledge

Abstract

Context/Background: Hypertension is a major contributor to cardiovascular mortality and morbidity worldwide and in India. Educational interventions can create opportunities for patients to better understand their conditions and the role of therapies, as well as heighten awareness about disease progression and complications. This study was conducted to evaluate the effectiveness of an interactive health education program in comparison with self-reading learning on blood pressure control.

Methodology: This study was a non-randomised controlled trial, involving 66 hypertensive patients from the eight villages in Kamjong district, Manipur. Participants were allocated to one of the two groups; intervention group (interactive health education) and control group (self-reading learning). Changes in blood pressure, Hypertension-related knowledge, attitude, lifestyle, adherence to medications and anthropometric parameters at three months post intervention from baseline were measured. Data was analysed using SPSS for Windows (Version 26.0).

Results: Three months post intervention, intervention group had more knowledge and adherence and better attitude as compared to the control. There was no significant change in the proportion of participants with controlled blood pressure in both the groups. Changes in lifestyle and anthropometric parameters were not significant.

Conclusions: Interactive health education is effective in terms of improvement in knowledge about hypertension, adherence to medication and attitude towards hypertension. A longer follow up might be needed to see changes in blood pressure control.

References

Carey RM, Muntner P, Bosworth HB, Whelton PK. Reprint of: Prevention and Control of Hypertension: JACC Health Promo-tion Series. J Am Coll Cardiol. 2018;72:1278-93. Doi: https://doi.org/10.1016/j.jacc.2018.07.008 PMid:30190007 PMCid:PMC6481176

Begum ML, Dhar SP, Mahmud A, Abedin MF, Lima LS, Khan MZ. Knowledge, attitude and practice of life style modification in the management of hypertension. Med clin Res. 2017;2:1-4. Doi: https://doi.org/10.33140/MCR.02.03.07

World Health Organization. A global brief on Hypertension; Silent killer, global public health crisis [Internet]. Gene-va:WHO;2013 [Cited 2020 October 10]. Available at : http://apps.who.int/iris/bitstream/10665/79059/1/WHO_DCO_WHD_2013.2_eng.pdf.Document # WHO/DCO/WHD/2013

Ozoemena EL, Iweama CN, Agbaje OS, Umoke PC, Ene OC, Ofili PC, et al. Effects of a health education intervention on hyper-tension-related knowledge, prevention and self-care practic-es in Nigerian retirees: a quasi-experimental study. Archives of Public Health. 2019;77:1-16. Doi: https://doi.org/10.1186/s13690-019-0349-x

World Hypertension Leaque. World Hypertension Day [In-ternet]. Geneva:WHL;2018 [Cited 2020 October 10]. Availa-ble at: http://www.whleaque.org/index.php/features/world-hypertension-day

Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation. 2016;134:441-50. Doi: https://doi.org/10.1161/CIRCULATIONAHA.115.018912 PMid:27502908 PMCid:PMC4979614

Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Ange-lantonio E, et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness and control of hypertension. J Hypertens. 2014;32:1170-7. Doi: https://doi.org/10.1097/HJH.0000000000000146 PMid:24621804 PMCid:PMC4011565

World Health Organization. Noncommunicable diseases country profiles [Internet]. Geneva: WHO;2018 [Cited 2020 October 10]. Available at http://www.who.int/nhm/countries/ ind_en.pdf

Gupta R. Trends in hypertension epidemiology in India. J Hum Hypertens. 2004;18:73-8. Doi: https://doi.org/10.1038/sj.jhh.1001633 PMid:14730320

Kumar SK, Akoijam BS, Asem P. Prevalence, awareness, treatment and control of hypertension in urban communities of Imphal, Manipur. International Journal of Interdisciplinary and Multidisciplinary Studies. 2015;2:61-70.

Bhattacharjya H, Debbarman DK, Tripura A, Baidya S, Devi LU, Singh AB, et al. Prevalence, determinants and awareness re-garding hypertension among adults in a rural area of Manipur. J Evol Med Dent Sci. 2013;2:10133-43. Doi: https://doi.org/10.14260/jemds/1747

Ribeiro AG, Ribeiro SM, Dias CM, Ribeiro AQ, Castro FA, Sua-rez-Varela MM, et al. Non-pharmacologic treatment of hyper-tension in primary health care: a comparative clinical trial of two education strategies in health and nutrition. BMC Public Health. 2011;11:637. Doi: https://doi.org/10.1186/1471-2458-11-637 PMid:21831277 PMCid:PMC3171370

Shaw R, Bosworth HB. Baseline medication adherence and blood pressure in a 24 month longitudinal hypertension study. J Clin Nurs. 2012;21:1401-6. Doi: https://doi.org/10.1111/j.1365-2702.2011.03859.x PMid:22107599 PMCid:PMC3291791

Meyer D, Leventhal H, Gutmann M. Common-sense models of illness: the example of hypertension. Health Psychol. 1985;4:115-35. Doi: https://doi.org/10.1037/0278-6133.4.2.115 PMid:4018002

Wade AH, Weir DN, Cameron AP, Tett SE. Using a Problem De-tection Study (PDS) to identify and compare health care pro-vider and consumer views of antihypertensive therapy. J Hum Hypertens. 2003;17:397-405. Doi: https://doi.org/10.1038/sj.jhh.1001565 PMid:12764402

Magadza C, Radloff SE, Srinivas SC. The effect of an educational intervention on patients' knowledge about hypertension, be-liefs about medicines, and adherence. Res Social Adm Pharm. 2009;5:363-75. Doi: https://doi.org/10.1016/j.sapharm.2009.01.004 PMid:19962679

Saonatsou M, Patsio O, Fasoi G, Stylianou M, Kavga A, Econo-mou Q, et al. The influence of the hypertensive patients' edu-cation in compliance with their medication. Public Health Nursing. 2001;18:436-42. Doi: https://doi.org/10.1046/j.1525-1446.2001.00436.x PMid:11737812

Lu CH, Tang ST, Lei YX, Zhang MQ, Lin WQ, Ding SH, et al. Community-based interventions in hypertensive patients: a comparison of three health education strategies. BMC Public Health. 2015;15:1-9. Doi: https://doi.org/10.1186/s12889-015-1401-6 PMid:25631224 PMCid:PMC4314804

Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self reported measure of medication adherence. Med Care. 1986;24(1):67-74. Doi: https://doi.org/10.1097/00005650-198601000-00007 PMid:3945130

National Institute for Health and Care Excellence. Hyperten-sion in adults: diagnosis and management [Internet]. London: NICE;2019 [Cited 2020 November 20]. Available at https://www.nice.org.uk/guidance/ng136/documents/draft-guideline

He J, Irazola V, Mills KT, Poggio R, Beratarrechea A, Dolan J, et al. Effect of a community health worker-led multicomponent intervention on blood pressure control in low-income pa-tients in Argentina: a randomized clinical trial. Jama. 2017;318: 1016-25. Doi: https://doi.org/10.1001/jama.2017.11358 PMid:28975305 PMCid:PMC5761321

Jafar TH, Gandhi M, de Silva HA, Jehan I, Naheed A, Finkelstein EA, et al. A Community-Based Intervention for Managing Hy-pertension in Rural South Asia. N Engl J Med. 2020 Feb; 382:717-26. Doi: https://doi.org/10.1056/NEJMoa1911965 PMid:32074419

Victor RG, Lynch K, Li N, Blyler C, Muhammad E, Handler J, et al. A Cluster-Randomized Trial of Blood Pressure Reduction in Black Barbershops. N Engl J Med. 2018;378:1291-301. Doi: https://doi.org/10.1056/NEJMoa1717250 PMid:29527973 PMCid:PMC6018053

Delavar F, Pashaeypoor S, Negarandeh R. The effects of self-management education tailored to health literacy on medica-tion adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial. Patient education and counseling. 2020;103:336-42. Doi: https://doi.org/10.1016/j.pec.2019.08.028 PMid:31451361

Jafari F, Shahriari M, Sabouhi F, Farsani AK, Babadi ME. Effects of a lifestyle modification program on knowledge, attitude and practice of hypertensive patients with angioplasty: A randomized controlled clinical trial. International journal of community based nursing and midwifery. 2016;4:286-96.

Kurnia AD, Melizza N, Ruhyanudin F, Masruroh NL, Prasetyo YB, Setyowati CI, et al. The Effect of Educational Program on Hypertension Management Toward Knowledge and Attitude Among Uncontrolled Hypertension Patients in Rural Area of Indonesia. Community Health Equity Research & Policy. 2022; 42:181-8. Doi: https://doi.org/10.1177/0272684X20972846 PMid:33256570