A Community-Based Intervention for Improving Medication Adherence for Elderly Patients with Hypertension in Korea

Abstract

The chronic disease management program, a community-based intervention including patient education, recall and remind service, and reduction of out-of-pocket payment, was implemented in 2005 in Korea to improve patients’ adherence for antihypertensive medications. This study aimed to assess the effect of a community-based hypertension intervention intended to enhance patient adherence to prescribed medications. This study applied a non-equivalent control group design using the Korean National Health Insurance Big Data. Hongcheon County has been continuously implementing the intervention program since 2012. This study involved a cohort of patients with hypertension aged >65 and <85 years, among residents who lived in the study area for five years (between 2010 and 2014). The final number of subjects was 2685 in both the intervention and control region. The indirect indicators were analyzed as patients’ adherence and level of continuous treatment using the difference-in-difference regression. The proportion of hypertensive patients who continuously received insurance benefits for >240 days in 2014 was 81.0% in the intervention region and 79.7% in the control region. The number of dispensations per prescription and the dispensation days per hypertensive patient in the intervention region increased by approximately 10.88% and 2.2 days on average by month, respectively, compared to those in the control region. The intervention program encouraged elderly patients with hypertension to receive continuous care. Another research is needed to determine whether further improvement in the continuity of comprehensive care will prevent the progression of cardiovascular diseases.

Effectivity of Indonesia Chronic Disease Management Program (PROLANIS) to Control Hypertension and its Comorbidities at Primary Health Care

“…The previous study from other area in Indonesia found that PROLANIS is effective to control BP through health status monitoring, club activity, home visit, and education on the eating pattern and physical activities programs [7]. Other studies from Korea also showed that population-based intervention is beneficial in improving hypertensive patients' adherence to medication [8]. Lu et al also concluded that population-based hypertension intervention could help improving BP control, especially the intervention involving interactive session; this method was more effective compared to self-study and classical lecture [9].…”

Trained health extension workers correctly identify high blood pressure in rural districts of northwest Ethiopia: a diagnostic accuracy study

“…The ending Eclampsia project in Nigeria showed community health extension workers at primary health care facilities can correctly measure BP, detect high BP, and treat accordingly for severe pre-eclampsia and eclampsia [ 52 ]. In Korea, a community-based interventions led by CHWs have shown promising results in early detection of hypertension, linkage to health facilities, improved medication adherence, and BP control [ 53 ]. Similarly, a study conducted in low and middle income countries confirmed that CHWs can detect and treat individuals with hypertension and other priority chronic diseases with proper training, supervision and logistical support [ 54 ].…”

Prioritizing Community-Based Intervention Programs for Improving Treatment Compliance of Patients with Chronic Diseases: Applying an Analytic Hierarchy Process

“…Our researchers, who had participated in the planning and evaluating Hongcheon-gun Hypertension and Diabetes Registration and Education Program for the past eight years [ 78 , 79 ], finally selected two opposing views of community-based intervention programs as policy alternatives to the AHP evaluation model that faced new challenges amid drastic changes in health policies in Korea. Unlike other AHP studies [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ], this study largely had a three-step mixed process.…”