Healthcare professional-led interventions on lifestyle modifications for hypertensive patients – a systematic review and meta-analysis

Trečiokienė, Indrė; Postma, Maarten; Nguyễn, Thắng; Fens, Tanja; Petkevicius, Jurgis; Kubilius, Raimondas; Gulbinovič, Jolanta; Taxis, Katja

doi:10.1186/s12875-021-01421-z

Cited by 22 publications

(18 citation statements)

References 59 publications

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“…In addition, the finding is consistent with the study of care models, emphasizing the role of healthcare workers in modifying Kaewkerd O, et al lifestyles of hypertension patients 14 . Patients had a decrease in blood pressure, while contraction of the heart decreased by nearly 5 mmHg, and more patients were able to control their blood pressure.…”

Section: Phase 2: Development Of the Model Of Promoting Knowledge And...supporting

confidence: 87%

An Action Research to Develop a Model of Promoting Knowledge and Behavioral Adjustment of Hypertensive Patients

Kaewkerd¹,

Chaiyasit²,

Pamulila³

et al. 2023

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This research aimed to develop a model of promoting knowledge and behavioral adjustment of hypertensive patients. MATERIALS AND METHODS: This action research was based on the concept of Kemmis and Mc Taggart (1988). The sample of 34 people consisted of 24 hypertensive patients and 10 community health volunteers. The research instruments were divided into the following two parts: 1) a general information questionnaire for older adults; 2) a qualitative data collection instrument consisting of semi-structured interviews, focus group discussions, and observations. The study was conducted between 30 November 2021-10 March 2022. Quantitative data were statistically analyzed by using frequency, percentage, mean and standard deviation. Qualitative data analysis used thematic analysis. RESULTS: A model of promoting knowledge and behavior adjustment was developed for hypertensive patients through community participation. Both cycles found that there were 4 development activities: 1) educating knowledge to hypertensive patients; 2) education about behavior modification; 3) providing models to transfer knowledge; 4) exchanging knowledge and using learning materials. Knowledge increased considerably, averaging from 14.87 ± 5.21 to 17.37 ± 4.65 (t = -2.882, p = 0.010, 95%CI -4.368 to -0.685). Hypertension complications prevention behavior of hypertensive patients was a high score, with diet control of 87.50 %, exercise at 91.70%. After the second round, hypertension patients were satisfied to develop a model of promoting knowledge and behavioral adjustment, at an higher number and percentage after developing a model from 18 (75.00%) to 21 (87.50%). After developing a model, and having completed the second round, community health volunteers classified the satisfaction of hypertension patients. This showed an increased satisfaction to develop a model of promoting knowledge and behavioral adjustment of hypertensive patients from 8 (80.00%) to 10 (100%). CONCLUSION: Nurses and healthcare workers should focus on educating and promoting the participation of patients and community health volunteers in encouraging hypertension patients to engage in self-care.

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Section: Phase 2: Development Of the Model Of Promoting Knowledge And...supporting

confidence: 87%

An Action Research to Develop a Model of Promoting Knowledge and Behavioral Adjustment of Hypertensive Patients

Kaewkerd¹,

Chaiyasit²,

Pamulila³

et al. 2023

bkkmedj

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“…Non-pharmacological management is the first line of hypertension treatment ( Table 9 ). Healthy lifestyle choices can reduce cardiovascular risk [ 37 ] and once applied in people with elevated BP, lifestyle modifications can increase the rates of BP control and enhance the effect of antihypertensive medication by further lowering BP [ 38 ].…”

Section: Results - Consensus Statementsmentioning

confidence: 99%

National Heart Center/Saudi Heart Association 2023 Guidelines on the Management of Hypertension

AlHabeeb¹,

Tash²,

Alshamiri³

et al. 2023

Journal of the Saudi Heart Association

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Background Hypertension is a highly prevalent disease in Saudi Arabia with poor control rates. Updated guidelines are needed to guide the management of hypertension and improve treatment outcomes. Methodology A panel of experts representing the National Heart Center (NHC) and the Saudi Heart Association (SHA) reviewed existing evidence and formulated guidance relevant to the local population, clinical practice and the healthcare system. The recommendations were reviewed to ensure scientific and medical accuracy. Recommendations Hypertension was defined and a new classification was proposed as relevant to the Saudi population. Recommendations on diagnosis, clinical evaluation, cardiovascular assessment were detailed, along with guidance on measurement modalities and screening/follow-up. Non-pharmacological management is the first line of hypertension treatment. Pharmacological therapy should be used appropriately as needed. Treatment priority is to control blood pressure regardless of the drug class used. The choice of treatment should be tailored to the patient profile in order to achieve treatment targets and ensure patient compliance. Recommendations were provided on pharmacological options available in Saudi Arabia, as well as guidance on the treatment of special conditions. Conclusion Hypertension management should be based on appropriate screening, timely diagnosis and lifestyle changes supplemented with pharmacological therapy, as needed. Clinical management should be individualized, and careful consideration should be given to special conditions and patient groups.

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“…A review of health care provider-led interventions on lifestyle modification in hypertensive patients in high-income countries [ 65 ] supports the idea that this approach can contribute to lowering elevated BP. Therefore, the apparent lack of increased hypertension control when adding the intervention component targeting hypertensive patients on top of our provider component is somewhat surprising.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a provider and patient-focused intervention to improve hypertension management and control in the primary health care setting in Cuba: a controlled before-after study

et al. 2023

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Background Implementation research to improve hypertension control is scarce in Latin America. We assessed the effectiveness of an intervention aimed at primary care practitioners and hypertensive patients in a setting that provides integrated care through an accessible network of family practices. Methods We conducted in Cardenas and Santiago, Cuba, a controlled before-after study in 122 family practices, which are staffed with a doctor and a nurse. The intervention comprised a control arm (usual care), an arm with a component targeting providers (hypertension management workshops), and an arm with, on top of the latter, a component targeting patients (hypertension schools). To evaluate the effect, we undertook a baseline survey before the intervention and an endline survey sixteen months after its start. In each survey, we randomly included 1400 hypertensive patients. Controlled hypertension, defined as a mean systolic and diastolic blood pressure below 140 and 90 mmHg, respectively, was the primary endpoint assessed. We performed linear and logistic regression with a Generalized Estimating Equations approach to determine if the proportion of patients with controlled hypertension changed following the intervention. Results Seventy-three doctors, including substitutes, and 54 nurses from the 61 intervention family practices attended the provider workshops, and 3308 patients −51.6% of the eligible ones- participated in the hypertension schools. Adherence to anti-hypertensive medication improved from 42% at baseline to 63% at the endline in the intervention arms. Under the provider intervention, the proportion of patients with controlled hypertension increased by 18.9%, from 48.7% at baseline to 67.6% at endline. However, adding the component that targeted hypertensive patients did not augment the effect. Compared to patients in the control arm, the adjusted OR of having controlled hypertension was 2.36 (95% CI, 1.73–3.22) in the provider and 2.00 (95% CI, 1.68–2.37) in the provider plus patient intervention arm. Conclusions The intervention’s patient component remains to be fine-tuned. Still, we demonstrate that it is feasible to substantially improve hypertension outcomes by intervention at the primary care level, despite an already relatively high control rate.

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Healthcare professional-led interventions on lifestyle modifications for hypertensive patients – a systematic review and meta-analysis

Cited by 22 publications

References 59 publications

An Action Research to Develop a Model of Promoting Knowledge and Behavioral Adjustment of Hypertensive Patients

An Action Research to Develop a Model of Promoting Knowledge and Behavioral Adjustment of Hypertensive Patients

National Heart Center/Saudi Heart Association 2023 Guidelines on the Management of Hypertension

Effectiveness of a provider and patient-focused intervention to improve hypertension management and control in the primary health care setting in Cuba: a controlled before-after study

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