Evaluation of a community‐based hypertension self‐management model with general practitioners

Abstract

Summary Background Preventive interventions of hypertension and health care activities are often performed in the community and at home. Studies have shown that self‐management plays an indispensable role in the management of chronic diseases. This study aimed to explore an innovative community‐based hypertension self‐management model and to evaluate its effects. Methods The study involved qualitative and quantitative research methods. A community‐based hypertension self‐management model was developed using consultation with experts and qualitative interviews. The intervention was executed in the communities of Pudong New Area in Shanghai, China. We enrolled 1080 patients with hypertension in the intervention group and 588 similar patients in the control group. A questionnaire was administered before and after the intervention to collect information on patients' health status, self‐management skills, and disease management abilities. Analyses were conducted to evaluate changes in the health‐related outcomes. Results There was a significant difference in general health and health literacy after the intervention for the intervention patients group (P < .05). Furthermore, the proportion of health literacy was higher in the intervention group than in the control group (71.6% vs 59.6%). The significant differences were demonstrated in the comparison of the disease management ability data between the intervention and control group, especially in drug compliance, physical activity, regulate diet, and smoking. In addition, there is other evidence of the successful applicability and effectiveness of the community‐based hypertension self‐management program in 2007‐2013, such as self‐management teams formation and blood pressure control rate. Conclusions The community‐based self‐management hypertension model, which involved the participation of general practitioners, is suitable for the management of hypertension disease in Pudong of Shanghai and could provide a reference for its large‐scale promotion and application.

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“…In which 320 000 patients of 20 000 selfmanagement groups were individuals with hypertension, representing 9% of all hypertension awareness patients aged 18 years or older in Shanghai. 22 The T2DM electronic clinical pathway diagnosis and treatment information platform was based on Chinese T2DM clinical guidelines (for primary care) 23 to standardise GPs' diagnosis, treatment, and management of T2DM patients. GPs take responsibility for glycaemic control of every patient they are assigned to.…”

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“…Regarding medical services, primary healthcare at the community‐level has played an essential role in supporting patients with their self‐management in the contemporary province, so it does in other districts of China 35,36 . Except for medical services, health‐related policy, and social networks weigh heavily as well.…”

“…Regarding medical services, primary healthcare at the community‐level has played an essential role in supporting patients with their self‐management in the contemporary province, so it does in other districts of China. 35 , 36 Except for medical services, health‐related policy, and social networks weigh heavily as well. Some patients are willing to engage in social participation and exchanging information, which could help them with adherent using of medicines, improvement of sleep hygiene, and doing more exercise.…”

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