Effects of self‐management programs on blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension: Meta‐analysis of randomized controlled trials

Trường, Phạm Văn; Apriliyasari, Renny Wulan; Lin, Mei; Chiu, Hsiao‐Yean; Tsai, Pei‐Shan

doi:10.1111/ijn.12920

Cited by 15 publications

(14 citation statements)

References 51 publications

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“…The partial mediating effect of SLE on the prospective reciprocal relationships between self-perceived disease control and these self-management behaviours accounted for only 37.11, 25.88, and 19.39% of the total effect of self-perceived disease control on medication use, self-monitoring and physical activity, respectively. Moreover, consistent with previous studies [ 20 , 50 , 79 , 80 ], our results proved that the significant effectiveness of medication therapy in disease control led to the strongest predictive effects of self-perceived disease control and SLE for medication use; middle-aged and older hypertensive patients are more likely to adhere to self-monitoring behaviour than they are to physical activity. The reason may be that medication use is the most timely and effective way to control hypertension among all self-management behaviours [ 81 , 82 ], and self-monitoring behaviour is easy to adhere to because self-monitoring requires less effort than physical activity [ 83 ].…”

Section: Discussionsupporting

confidence: 91%

Interaction between self-perceived disease control and self-management behaviours among Chinese middle-aged and older hypertensive patients: the role of subjective life expectancy

et al. 2022

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Background One of the effective ways to control hypertension is long-term self-management, which is difficult to maintain. Therefore, understanding how people engage in the process of self-management behaviour change is necessary. In this study, we aimed to examine the dynamic relationship between self-perceived disease control and self-management behaviours in Chinese middle-aged and older hypertensive patients, namely, medication use, self-monitoring, physical activity, tobacco and alcohol avoidance, and to explore the mediating role of subjective life expectancy (SLE) on this relationship. Methods Data were obtained from a nationally representative sample of 508 middle-aged and older hypertensive patients (aged 45+) from the 2013, 2015, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. A cross-lagged panel model combined with mediation analysis was used to determine the dynamic relationship between self-perceived disease control and self-management behaviours and to clarify the mediating effect of SLE on this ascertained relationship. Results Good self-perceived disease control subsequently predicted good medication use, self-monitoring and physical activity, and vice versa. Subjective life expectancy (SLE) partially mediated the prospective reciprocal relationships between self-perceived disease control and these self-management behaviours, which accounted for 37.11, 25.88, and 19.39% of the total effect of self-perceived disease control on medication use, self-monitoring and physical activity, respectively. These self-management behaviours had a significant and positive feedback effect on self-perceived disease control. However, neither the direct and indirect effects (via SLE) of self-perceived disease control on tobacco and alcohol avoidance were revealed. Conclusions Positive feedback loops of present self-perceived disease control, future SLE and self-management behaviours (medication use, self-monitoring, and physical activity) help middle-aged and older hypertensive patients adhere to these behaviours but are useless for the avoidance of addictive behaviours. Interventions aimed at enhancing the effect perception of general self-management behaviours (e.g., medication use, self-monitoring and physical activity) on the present disease control perspective, and future lifespan perspective would be beneficial for the consistent self-management behaviours of middle-aged and older hypertensive patients. The utility of present disease control perception to these self-management behaviours was much higher than the utility of future expectations. Alternative stress relief strategies may be conducive to long-term changes in addictive behaviours.

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Section: Discussionsupporting

confidence: 91%

Interaction between self-perceived disease control and self-management behaviours among Chinese middle-aged and older hypertensive patients: the role of subjective life expectancy

et al. 2022

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“…3 After selfmanagement support, it was determined that there was a significant decrease in the blood pressure of patients in the intervention group, and the mean blood pressure values measured by the researcher were in the normal classification according to the ESC Guidelines for the Management of Arterial Hypertension. 3 The results of our study are consistent with the results of other studies in the literature and show that self-management support 16,32,33 , and disease-specific education 25,34,35 have a significant effect on decreasing systolic and diastolic blood pressure values.…”

Section: Discussionsupporting

confidence: 91%

The effect of self-management support on knowledge level, treatment compliance and self-care management in patients with hypertension

Kurt¹,

Gurdogan²

2022

AJAN

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Objective: This study was carried out to determine the effect of self-management support given to patients diagnosed with hypertension on the hypertension knowledge level, treatment adherence and self-care management, and to examine the changes in patients' blood pressure after the selfmanagement support. Background:The rise of chronic diseases such as hypertension necessitates the equipment of patients with sufficient knowledge and skills necessary to manage their disease and self-care.Methods: This randomised controlled research was conducted with a total of 137 patients, including 69 intervention and 68 control patients. Data were collected using the "Patient Information Form", "Hypertension Knowledge-Level Scale", "Hill-Bone Compliance to High Blood Pressure Therapy Scale" and "Self Care Management Process in Chronic Illness Scale" at the first interview and the last interview three months after the first interview. One week after the first interview, the patients in the intervention group received self-management support including information about hypertension and its management and blood pressure measurement skills. results: After self-management support, a significant improvement was found in hypertension knowledge level (p=0.000), treatment adherence (p=0.000), and self-care management (p=0.000) of patients in the intervention group A significant decrease was determined in systolic (p=0.000) and diastolic blood pressure (p=0.000) of patients in the intervention group. conclusion: Self-management support has shown positive effects in increasing hypertension knowledge level, adherence to hypertension treatment, self-care management, and blood pressure control in patients diagnosed with hypertension. This study also provides nurses with an approach in which they can effectively use training and counselling roles for patients. implications for research, policy, and practice: Patients diagnosed with hypertension should be educated by nurses about the disease. Nurses should teach the patients who are diagnosed with hypertension the ability to monitor their blood pressure at home. Cardiovascular rehabilitation nursing units should be established in hospitals to provide more effective self-management support to hypertensive patients.

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“…Our results demonstrating participants in the web‐based self‐care program had significant improvements in self‐efficacy and self‐care strengthen previous findings showing individualized health education intervention has been demonstrated to be beneficial for enhancing self‐efficacy of achieving blood pressure control (Van Truong et al, 2021).…”

Section: Discussionsupporting

confidence: 88%

“…The effect of self‐efficacy on medication adherence for participants in the intervention group echo the results of a meta‐analysis of 12 randomized controlled trials by Van Truong et al (2021), which showed self‐care management programs facilitate medication adherence for older adults with hypertension. Sevick et al (2018) suggested the challenge of changing a person's lifestyle is to construct new knowledge and skills in such a way that barriers can be overcome without too much effort.…”

Section: Discussionsupporting

confidence: 62%

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A web‐based self‐care program to promote healthy lifestyles and control blood pressure in patients with primary hypertension: A randomized controlled trial

Chen

Kao

Cheng

et al. 2022

J of Nursing Scholarship

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Background Hypertension is a major risk factor for cardiovascular diseases, which contributes to the worldwide mortality rate. Successful blood pressure control requires adherence to medications and lifestyle modifications. However, motivating patients with primary hypertension to change and sustain behaviors long‐term is challenging. A web‐based self‐care program centered on self‐efficacy theory could provide feedback for effective control of blood pressure. Purpose To examine the effect of a web‐based self‐care program for patients with primary hypertension on cardiovascular risk‐factors (pulse pressure and lipids), self‐efficacy, and self‐care behaviors (medication adherence and lifestyle). Design A two‐armed randomized controlled trial with 3‐month and 6‐month follow‐ups. Setting and Participants A total of 222 patients with primary hypertension were recruited between February 2017 and August 2018 at a cardiology clinic of a medical center in Taipei, Taiwan. Methods Eligible patients were randomized by permuted block randomization into the intervention group (n = 111) and control group (n = 111). Patients in the intervention group received a 6‐month web‐based self‐care program, based on the theory of self‐efficacy, while patients in the control group received usual care. Baseline and outcome measures (3 and 6 months) included self‐efficacy, evaluated with the Chinese version of the 6‐item Self‐Efficacy for Managing Chronic Diseases (SEMC6), self‐care, using subscales of the Hypertension Self‐Care Activity Level Effects Scale (H‐SCALE) for lifestyle and medication adherence, and blood pressure and serum lipid data, collected through web‐based self‐reports and chart review. Generalized estimating equations evaluated the effects of the intervention. Findings At baseline, the control group had higher scores on the SEMC6, and lower cholesterol (HDL) compared with the intervention group (t = −2.70, p < 0.05; and t = 1.76, p < 0.05, respectively). Pulse pressure decreased significantly (β = −20.30, 95% CI −23.76, −16.83), and serum triglycerides and low‐density lipoprotein cholesterol levels were significantly lower compared with controls at 6 months (all p < 0.001). At 6 months, the intervention group had significantly higher mean scores for the SEMC6 compared with the control group (β = 21.84, 95% confidence interval [CI] 19.25, 24.42) and H‐SCALE subscale for medication adherence, diet, weight management, and physical activity compared with controls at 6 months (all, p < 0.001). Conclusions and clinical relevance The greatest benefit of this program was allowing participants to immediately consult with the researchers about self‐care issues via the website. Lifestyles vary from person to person; therefore, the individuality of each participant was considered when providing feedback. We provided devising interventions for participants that would increase their confidence in self‐care for hypertension and ultimately achieve home blood pressure control. We encourage incorporating this program into standard ...

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Effects of self‐management programs on blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension: Meta‐analysis of randomized controlled trials

Cited by 15 publications

References 51 publications

Interaction between self-perceived disease control and self-management behaviours among Chinese middle-aged and older hypertensive patients: the role of subjective life expectancy

Interaction between self-perceived disease control and self-management behaviours among Chinese middle-aged and older hypertensive patients: the role of subjective life expectancy

The effect of self-management support on knowledge level, treatment compliance and self-care management in patients with hypertension

A web‐based self‐care program to promote healthy lifestyles and control blood pressure in patients with primary hypertension: A randomized controlled trial

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