Take Control of Your Blood pressure (TCYB) study: A multifactorial tailored behavioral and educational intervention for achieving blood pressure control

Abstract

Objectives-Evaluating a randomized controlled trial involving a tailored behavioral intervention conducted to improve blood pressure control.Methods-Adults with hypertension from two outpatient primary care clinics were randomly allocated to receive a nurse-administered behavioral intervention or usual care. In this ongoing study, patients receive the tailored behavioral intervention bi-monthly for two years via telephone; the goal of the intervention is to promote medication adherence and improve hypertension-related health behaviors. Patient factors targeted in the tailored behavioral intervention include perceived risk of hypertension and knowledge, memory, medical and social support, patients' relationship with their health care provider, adverse effects of medication therapy, weight management, exercise, diet, stress, smoking, and alcohol use.Results-The sample randomized to the behavioral intervention consisted of 319 adults with hypertension (average age = 60.5 years; 47% African-American). A comparable sample of adults was assigned to usual care (n=317). We had a 96% retention rate for the overall sample for the first 6 months of the study (93% at 12 months). The average phone call has lasted 18 minutes (range 2 to 51 minutes). From baseline to six months, self-reported medication adherence increased by 9% in the behavioral group vs. 1% in the non-behavioral group.Conclusion-The intervention is easily implemented and is designed to enhance adherence with prescribed hypertension regimen. The study includes both general and patient-tailored information based upon need assessment. The study design ensures internal validity as well as the ability to generalize study findings to the clinic settings. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Practice Implications-Despite knowledge of the risks and acceptable evidence, a large number of hypertensive adults still do not have their blood pressure under effective control. This study will be an important step in evaluating a tailored multibehavioral intervention focusing on improving blood pressure control. NIH Public Access

Medication Non-Adherence After Myocardial Infarction: An Exploration of Modifying Factors

“…15 Additionally, health literacy was assessed via the Rapid Estimate of Adult Literacy in Medicine (REALM) score, which we dichotomized as ≤60 (<9th grade reading level) or ≥61 (≥9th grade reading level). [15][16][17] We also evaluated knowledge of cardiovascular disease risk factors using a validated continuous measure. 18 Medical comorbidities included diabetes status, history of stroke, smoking status, and body mass index.…”

“…15,17 If patients did not respond to any one of the four items, the non-adherence variable was considered as missing.…”

Assessment of self-care practices among hypertensive patients: a clinic based study in rural area of Singur, West Bengal

“…Previous studies had shown that compliance with hypertension self-care guidelines such as weight reduction, smoking cessation, low sodium diet, diet rich in fruit, vegetables and low-fat diet, physical activity and stress management can substantially control blood pressure. 11,12 Most of the studies emphasize on the benefits of medication adherence alone, but very few studies have thrown light over the importance of healthy lifestyle that is essential in controlling hypertension. With this background, an attempt was made in the present study to assess the pattern of self-care practices and the factors associated with it, among hypertensive patients in a rural area of Singur, West Bengal.…”

Yaşlılarda Hipertansiyon Yönetiminde Hemşirenin Rolü

“…[40][41][42] Bu nedenle birinci basamak sağlık kurumlarında çalışan hemşireler tarafından hipertansiyon tedavisinde kullanılan ilaç grupları, ilaç içerik ve etkileşimleri iyi bilinmelidir. Hipertansif hastaların reçete edilmiş ilaçları, diğer ilaç geçmişleri ve tedaviye uyumu değerlendirilmelidir.…”