A clinical trial on the effect of a multifaceted intervention on blood pressure control and medication adherence in patients with uncontrolled hypertension

ARYA Atheroscler. 2019 Nov;15(6):267-274. doi: 10.22122/arya.v15i6.1904.

Abstract

Background: Hypertension (HTN) is the key risk factor for cardiovascular diseases (CVDs). The purpose of this study was to determine the effect of a multifaceted intervention on blood pressure (BP) control and medication adherence (MA) among patients with uncontrolled HTN.

Methods: A randomized controlled clinical trial study was conducted on 72 patients in the emergency ward who were selected through convenience sampling method. They were randomly divided into intervention and control groups. The studied multifaceted intervention includes motivational interviews and 90 minutes of training sessions, use of a drug reminder box, family support, and 4 phone call follow-ups. The8-Item Morisky Medication Adherence Scale (MMAS-8) was used before and after the intervention. BP was measured in both groups before and after the intervention and compared between them.

Results: No significant difference existed between the two groups in terms of MA and systolic and diastolic BP before the study. The differences between the mean changes in post-intervention systolic (-25.75 ± 19.39 vs. -2.88 ± 11.92 mmHG; P < 0.001) and diastolic (-6.18 ± 8.87 vs. -1.06 ± 8.70 mmHg; P = 0.010) BP in the intervention and control groups were statistically significant. The mean changes in post-intervention MA in the intervention and control group was 2.91 ± 1.64 and -0.36 ± 1.15, respectively; this difference was statistically significant (P < 0.001).

Conclusion: The studied multifaceted intervention promoted MA and reduced systolic and diastolic BP. Thus, the use of this method as a supplementary treatment is recommended after patient discharge.

Keywords: Blood Pressure; Hypertension; Iran; Medication Adherence; Nursing.