<p>A Community and Technology-Based Approach for Hypertension Self-Management (COACHMAN) to Improve Blood Pressure Control in African Americans: Results from a Pilot Study</p>

Abstract

Purpose: Adoption of technology has increased to support self-managing chronic diseases. However, behavioral interventions evaluating such technology have been understudied in African Americans with hypertension. The aim of this study was to explore a community and technology-based intervention for hypertension self-management (COACHMAN) intervention on blood pressure (BP) control and health-related quality of life (HRQoL) in African Americans with hypertension. Methods: Sixty African Americans (mean age 60; 75% females) who were prescribed antihypertensive medications and owning a smartphone were randomized to the COACHMAN (n = 30) or enhanced usual care (n = 30) group for 12 weeks. COACHMAN is comprised of four components: web-based education, home BP monitoring, medication management application, and nurse counseling. Hypertension knowledge, self-efficacy, technology adoption/use, medication adherence, BP, and HRQoL scores were assessed. Results: Mean systolic and diastolic BP at baseline was 150.49 (SD = 13.89) and 86.80 (SD = 13.39), respectively. After completing the 3-month intervention to improve hypertension selfmanagement, the groups did not significantly differ in BP control and HRQoL. Clinically relevant BP reduction was observed in the intervention group. Paired t-test showed that mean medication-taking adherence scores significantly improved in the intervention group (P = 0.023) compared to the control group (P = 0.075). Conclusion: Using technology may have a positive impact on supporting hypertension selfmanagement, particularly in medication-taking adherence. Further research is warranted in a larger sample and should include standardization of medication management to isolate the effects of behavioral interventions on changes in BP. Clinicaltrials.gov Identifier: NCT03722667.

The effect of drug information service using leaflet media and medication reminder chart on adherence and blood pressure of hypertensive patients in primary health care

“…Data karakteristik sosiodemografi, gaya hidup dan penyakit dianalisis secara deskriptif dalam bentuk frekuensi dan persentase. Kelompok intervensi dan kelompok kontrol dibandingkan untuk kesetaraan dalam karakteristik dasar menggunakan Chi-square (sebagai alternatif digunakan uji fisher atau Kruskal-wallis) untuk data kategorik (Still et al, 2020). Uji-t berpasangan digunakan untuk menganalisis perbedaan kepatuhan sebelum dan sesudah intervensi (sebagai alternatif digunakan uji mann-whitney).…”

Medication Safety in Municipal Health and Care Services

“…Overall, the nurse-led interventions were complex, with a variety of components that typically included personalized health or medication information (oral, written and/or digital), education, consultation, counseling and/or motivational interviewing performed by nurses in primary health clinics or home visits. eHealth components, that is information and communication technology in support of health education and/or health and medication management, were used in seven studies (Cicolini et al, 2014;Del Hoyo et al, 2018;Liang et al, 2021;Persell et al, 2018;Shen et al, 2021;Still et al, 2020;Wakefield et al, 2011). The eHealth intervention elements ranged in complexity, from relatively simple e-mail alerts (Cicolini et al, 2014) and apps (Del Hoyo et al, 2018), to a complex integrated tele-homecare program including a smartphone, blood pressure monitor, medication dispenser, glucometer and a necklace emergency call button (Liang et al, 2021).…”

“…The eHealth intervention elements ranged in complexity, from relatively simple e-mail alerts (Cicolini et al, 2014) and apps (Del Hoyo et al, 2018), to a complex integrated tele-homecare program including a smartphone, blood pressure monitor, medication dispenser, glucometer and a necklace emergency call button (Liang et al, 2021). Adherence aids were used in six interventions (Blank et al, 2014;Del Hoyo et al, 2018;Kolcu & Ergun, 2020;Liang et al, 2021;Simoni et al, 2011;Still et al, 2020).…”

“…The most commonly used measure was subjective self-reported adherence (n = 14, 82.3%). Two or more adherence measures were used in six studies out of the 17 (35.3%) (Adeyemo et al, 2013;Amado Guirado et al, 2011;Mayer et al, 2017;McAlister et al, 2019;Simoni et al, 2011;Still et al, 2020).…”

“…A medium or lower overall attrition (<20%), but unbalanced between groups, was classified as an unknown RoB, concerning two studies (Liang et al, 2021;Shen et al, 2021). Most studies had a low risk of reporting bias (n = 11), and four studies had an unclear risk of reporting bias due to for example, not showing a study flow diagram or not giving detailed data on adherence (Blank et al, 2011;Mayer et al, 2017;Simoni et al, 2011;Still et al, 2020). Two studies had a high risk of reporting bias due to missing data on adherence outcomes, and/or study flow diagrams, and/or study participants' health characteristics (Usher et al, 2013;Wakefield et al, 2011).…”