The Effect of Educational Program on Hypertension Management Toward Knowledge and Attitude Among Uncontrolled Hypertension Patients in Rural Area of Indonesia

Background Hypertension is a major public health threat affecting adults worldwide. The low hypertension management knowledge causes uncontrolled high blood pressure and it’s a complication. It requires patients with uncontrolled hypertension to increase adherence to either pharmacological therapy or nonpharmacological therapy aimed at achieving normal blood pressure. Purpose The purpose of this study was to examine the effectiveness of a short-term educational program on hypertension management related knowledge and attitude among uncontrolled hypertension patients in Malang, Indonesia. Methods The research design used a Quasi-Experimental study with the design of one group pre-post-test. The participants were 41 uncontrolled hypertension patients chosen by purposive sampling at the Ciptomulyo Public Health Center. The questionnaires were used to collect the data. The Hypertension Knowledge-Level Scale (HK-LS) questionnaire was used to determine the knowledge of uncontrolled hypertension patients. KAP questionnaire was used to determine the attitude of the participants. The data were analyzed statistically using the Wilcoxon Signed Rank Test. Results The majority of respondents were aged 55–65 (54%), female (83%), housewife (76%), graduated elementary school (71%), and long suffered from hypertension >1 year (68%). The result showed that the provision of the educational program increases knowledge (p = 0,000) and attitude (p = 0,008) of patients on the management of hypertension. Conclusion Health education could improve hypertension management knowledge and attitude among uncontrolled hypertension in the rural area. Furthermore, Health providers should consider giving the education among uncontrolled hypertension.

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Abstract 091: Improved Blood Pressure Control and High Adherence to a Novel Management Model of Hypertension Care in a West African Population

Hypertension ◽

10.1161/hyp.70.suppl_1.091 ◽

2017 ◽

Vol 70 (suppl_1) ◽

Author(s):

Isaac Owusu ◽

Fred Adomako-Boateng ◽

Fred Kueffer ◽

Molly Guy ◽

Chemuttaai Lang’at ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Pressure Control ◽

Management Plan ◽

West African ◽

Sub Saharan Africa ◽

Management Model ◽

Uncontrolled Hypertension ◽

Hypertension Management ◽

Software Application

Background: Logistic and socioeconomic barriers limit effective blood pressure (BP) control in many parts of Sub-Saharan Africa, including the Republic of Ghana. We tested a novel hypertension management model of care designed for resource-limited settings. Methods and Results: The “Akoma Pa” model was developed using human-centered design methodology involving patients, physicians, and nurses. The model consisted of a mobile tablet, BP machine and a novel software application in a unique platform to allow for longitudinal patient management. Patients were provided with a tailored hypertension management plan based on their enrollment comorbidities and risk factors. A cohort of 150 hypertensive patients (57±8 years; 73% female) accessed regular blood pressure assessments at a local pharmacy and received real-time automated feedback based on their individualized plan. On the mobile application, clinicians were able to view patient data, provide patients with feedback via SMS on their condition, and write electronic prescriptions which could be accessed by participating pharmacies. Average baseline BP was 135±18/84±10 mmHg in the overall cohort and 153±13/90±11 mmHg in the subgroup with uncontrolled hypertension (n=58). After 6 months of voluntary weekly monitoring, systolic blood pressure decreased significantly (p<0.01) in the overall cohort (-4.7±18.7 mmHg) and in the uncontrolled subgroup (-15.2±17.6mmHg). Systolic blood pressure remained constant in the sub group with controlled pressure at baseline. The proportion of the population with uncontrolled hypertension decreased from 39% to 27% (p=0.01). Patient compliance with weekly BP assessments was 61% and 2,855 BP assessments were conducted. During 33 of the 2,855 BP assessments (1% of pharmacy visits), the software application directly referred patients to a health facility (33 visits in 25 patients). Improvement in overall health awareness was reported in 82% of the participants and 95% of participants indicated a desire to continue using this model in the future. Conclusions: Compliance and satisfaction with this multifaceted hypertension care model were high and led to significant and sustained decreases in blood pressure in this West African hypertensive population.

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MASked-unconTrolled hypERtension management based on office BP or on ambulatory blood pressure measurement (MASTER) Study: a randomised controlled trial protocol

BMJ Open ◽

10.1136/bmjopen-2017-021038 ◽

2018 ◽

Vol 8 (12) ◽

pp. e021038 ◽

Cited By ~ 17

Author(s):

Gianfranco Parati ◽

Enrico Agabiti-Rosei ◽

George L Bakris ◽

Grzegorz Bilo ◽

Giovanna Branzi ◽

...

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Pressure Measurement ◽

Management Strategy ◽

Blood Pressure Measurement ◽

Uncontrolled Hypertension ◽

Hypertension Management ◽

Ambulatory Blood Pressure Measurement ◽

Group 2 ◽

Group 1

IntroductionMasked uncontrolled hypertension (MUCH) carries an increased risk of cardiovascular (CV) complications and can be identified through combined use of office (O) and ambulatory (A) blood pressure (BP) monitoring (M) in treated patients. However, it is still debated whether the information carried by ABPM should be considered for MUCH management. Aim of the MASked-unconTrolled hypERtension management based on OBP or on ambulatory blood pressure measurement (MASTER) Study is to assess the impact on outcome of MUCH management based on OBPM or ABPM.Methods and analysisMASTER is a 4-year prospective, randomised, open-label, blinded-endpoint investigation. A total of 1240 treated hypertensive patients from about 40 secondary care clinical centres worldwide will be included -upon confirming presence of MUCH (repeated on treatment OBP <140/90 mm Hg, and at least one of the following: daytime ABP ≥135/85 mm Hg; night-time ABP ≥120/70 mm Hg; 24 hour ABP ≥130/80 mm Hg), and will be randomised to a management strategy based on OBPM (group 1) or on ABPM (group 2). Patients in group 1 will have OBP measured at 0, 3, 6, 12, 18, 24, 30, 36, 42 and 48 months and taken as a guide for treatment; ABPM will be performed at randomisation and at 12, 24, 36 and 48 months but will not be used to take treatment decisions. Patients randomised to group 2 will have ABPM performed at randomisation and all scheduled visits as a guide to antihypertensive treatment. The effects of MUCH management strategy based on ABPM or on OBPM on CV and renal intermediate outcomes (changing left ventricular mass and microalbuminuria, coprimary outcomes) at 1 year and on CV events at 4 years and on changes in BP-related variables will be assessed.Ethics and disseminationMASTER study protocol has received approval by the ethical review board of Istituto Auxologico Italiano. The procedures set out in this protocol are in accordance with principles of Declaration of Helsinki and Good Clinical Practice guidelines. Results will be published in accordance with the CONSORT statement in a peer-reviewed scientific journal.Trial registration numberNCT02804074; Pre-results.

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The Effectiveness of Emo-Demo in Increasing the Knowledge and Attitudes in Mother Who Do Not Provide Exclusive Breastfeeding in the Working Area of Cisadae Public Health Center in Malang

KnE Life Sciences ◽

10.18502/kls.v0i0.8871 ◽

2021 ◽

Author(s):

Supriyadi . ◽

Septa Katmawanti ◽

Rosyada Firdausi ◽

Dea Aflah Samah

Keyword(s):

Public Health ◽

Health Center ◽

Exclusive Breastfeeding ◽

Urban Areas ◽

Rank Test ◽

Design Data ◽

Public Health Center ◽

Knowledge And Attitudes ◽

Breastfeeding Rate ◽

Knowledge And Attitude

The worldwide rate of exclusive breastfeeding is <40%. In Indonesia, only 42% of babies were exclusively breastfed for first six months by 96% of women (2013). Breast milk plays a vital role for both mother and baby. In 2018, the exclusive breastfeeding rate in East Java was 40%, which is far from the target set at 80%. The rate of exclusive breastfeeding is relatively higher in rural than in urban areas with a ratio of 57.22:54.77%. Meanwhile, in Malang, particularly in the Cisadea Public Health Center area, in 2019, the rate of exclusive breastfeeding was 64.8%. The knowledge and attitude of women are closely related to their behaviour towards exclusive breastfeeding. One way to increase the practice of exclusive breastfeeding is Emotional-Demonstration (Emo-Demo) education. The purpose of this study was to determine the effectiveness of Emo-Demo exclusive breastfeeding to increase the knowledge and attitudes of mothers who do not exclusively breastfeed in the working area of the Cisadea Public Health Center. The study used a pre-experimental research with one-group pre–post-test design. Data from the Wilcoxon signed rank test on maternal knowledge obtained an Asymp Sig (2-tailed) value of 0.011 and maternal attitude of 0.000. So, it can be concluded that the Emo-Demo method is effective in increasing the knowledge and attitude of mothers towards exclusive breastfeeding. Keywords: demo, exclusive breastfeeding, knowledge, attitude

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PENGARUH REBUSAN BUNGA ROSELLA TERHADAP PENURUNAN TEKANAN DARAH (HIPERTENSI) PADA PASIEN DI WILAYAH KERJA PUKESMAS SUKAMERINDU BENGKULU

Jurnal Sains Kesehatan ◽

10.37638/jsk.26.2.53-60 ◽

2019 ◽

Vol 26 (2) ◽

pp. 53-60

Author(s):

Vellyza Colin ◽

Buyung Keraman ◽

Evan Aditya Pratama

Keyword(s):

Public Health ◽

Blood Pressure ◽

Systolic Blood Pressure ◽

Health Center ◽

Rank Test ◽

P Value ◽

Wilcoxon Sign Rank Test ◽

Before And After ◽

Wilcoxon Sign Rank ◽

Sign Rank Test

The Effect of Rosella Stew to Decreasing of Blood Pressure (Hypertension) in Patients at Working Area of Sukamerindu Public Health Center BengkuluABSTRAKPengaruh rebusan bunga rosella terhadap penurunan tekanan darah (Hipertensi) pada pasien diwilayah kerja Puskesmas Sukamerindu Bengkulu. Hipertensi adalah peningkatan tekanan darah sistolik lebih dari 140 mmHg dan diastolik lebih dari 90 mmHg. Penelitian ini bertujuan untuk mempelajari pengaruh rebusan bunga rosella digunakan untuk menurunkan tekanan darah oleh sebagian masyarakat. Penelitian ini merupakan penelitian kuantiatif dengan desain pra exsprimental. Populasi dalam penelitian ini pasien hipertensi yang berobat di Puskesmas Sukamerindu Kota Bengkulu pada bulan Januari-Desember 2018 sebanyak 52 orang dewasa yang terkena hipertensi. Teknik pengambilan sample dengan total sampling dengan kriteria inkulasi dan ekslusi sehingga sample yang diambil 30 orang yang memenuhi kriteria dalam pemberian rebusan bunga rosella dan 22 orang yang tidak memenuhi kriteria dalam pemberian bunga rosella untuk penurunan tekanan darah hipertensi. Pengumpulan data dalam penelitian ini menggunakan data sekunder dengan melihat cacatan dokumentasi di Poli Umum Di Puskesmas Sukamerindu Bengkulu.Hasil penelitian didapatkan: uji statistik Wilcoxon Sign Rank Test Hasil tekanan darah sistolik sebelum dan sesudah perlakuan didapatkan nilai Z = -4,293 dengan p=value=0,0000,05 berarti signifikan, maka Ho ditolak dan Ha diterima. Jadi Ada pengaruh pemberian rebusan bunga rosella terhadap penurunan tekanan darah sistolik pada pasien diwilayah kerja Puskesmas Sukamerindu Kota Bengkulu. Hasil tekanan darah diastol sebelum dan sesudah perlakuam didapatkan nilai Z = -3,075 dengan p=value=0,0020,05 berarti signifikan, maka Ho ditolak dan Ha diterima. Jadi Ada pengaruh pemberian rebusan bunga rosella terhadap penurunan tekanan darah diastolik pada pasien diwilayah kerja Puskesmas Sukamerindu Kota Bengkulu. Kata Kunci : hipertensi, tekanan darah, rebusan rosella ABSTRACT Effect of rosella stew on blood pressure (hypertension) reduction in patients in the Pukesmas area Sukamerindu Bengkulu. Hypertension is an increase in systolic blood pressure of more than 140 mmHg and diastolic of more than 90 mmHg. This study discusses the benefits of rosella stew used for reducing blood pressure by most people. This research is a quantitative research with pre-exemplary design. The population in this study were hypertensive patients seeking treatment at the Sukamerindu Public Health Center in Bengkulu City in January-December 2018 as many as 52 adults affected by hypertension. Sampling technique with total sampling with inclusion and exclusion criteria so that the samples taken were 30 people who met the criteria in the provision of rosella stew and 22 people who did not meet the criteria for rosella stew for decreasing hypertension. Data collection in this study uses secondary data by looked at documentation records at Puskesmas Sukamerindu Bengkulu.The results of this study showed: Wilcoxon Sign Rank Test statistical test Results of systolic blood pressure before and after treatment obtained a value of Z = -4.293 with p = value = 0.000 0.05 means significant, then Ho is rejected and Ha is accepted. So there is Effect of rosella stew to Decreasing of blood pressure (hypertension) in patients at area of Pukesmas Sukamerindu Bengkulu. The results of diastolic blood pressure before and after the treatment showed that the value of Z = -3.075 with p = value = 0.002 0.05 means significant, then Ho was rejected and Ha was accepted. So there is Effect of rosella stew to Decreasing of blood pressure (hypertension) in patients at area of Pukesmas Sukamerindu Bengkulu. Keywords: blood pressure, hypertension, rosella stew

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Understanding the Feasibility, Acceptability, and Efficacy of a Clinical Pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: Mixed Methods Pilot Study

Journal of Medical Internet Research ◽

10.2196/19882 ◽

2020 ◽

Vol 22 (8) ◽

pp. e19882

Author(s):

Lorraine R Buis ◽

Dana N Roberson ◽

Reema Kadri ◽

Nicole G Rockey ◽

Melissa A Plegue ◽

...

Keyword(s):

Blood Pressure ◽

Pilot Study ◽

Clinical Pharmacist ◽

Blood Pressure Monitoring ◽

Home Blood Pressure ◽

Uncontrolled Hypertension ◽

Hypertension Management ◽

Home Blood Pressure Monitoring ◽

Pressure Monitoring

Background Hypertension is a prevalent and costly burden in the United States. Clinical pharmacists within care teams provide effective management of hypertension, as does home blood pressure monitoring; however, concerns about data quality and latency are widespread. One approach to close the gap between clinical pharmacist intervention and home blood pressure monitoring is the use of mobile health (mHealth) technology. Objective We sought to investigate the feasibility, acceptability, and preliminary effectiveness of BPTrack, a clinical pharmacist-led intervention that incorporates patient- and clinician-facing apps to make electronically collected, patient-generated data available to providers in real time for hypertension management. The patient app also included customizable daily medication reminders and educational messages. Additionally, this study sought to understand barriers to adoption and areas for improvement identified by key stakeholders, so more widespread use of such interventions may be achieved. Methods We conducted a mixed methods pilot study of BPTrack, to improve blood pressure control in patients with uncontrolled hypertension through a 12-week pre-post intervention. All patients were recruited from a primary care setting where they worked with a clinical pharmacist for hypertension management. Participants completed a baseline visit, then spent 12 weeks utilizing BPTrack before returning to the clinic for follow-up. Collected data from patient participants included surveys pre- and postintervention, clinical measures (for establishing effectiveness, with the primary outcome being a change in blood pressure and the secondary outcome being a change in medication adherence), utilization of the BPTrack app, interviews at follow-up, and chart review. We also conducted interviews with key stakeholders. Results A total of 15 patient participants were included (13 remained through follow-up for an 86.7% retention rate) in a single group, pre-post assessment pilot study. Data supported the hypothesis that BPTrack was feasible and acceptable for use by patient and provider participants and was effective at reducing patient blood pressure. At the 12-week follow-up, patients exhibited significant reductions in both systolic blood pressure (baseline mean 137.3 mm Hg, SD 11.1 mm Hg; follow-up mean 131.0 mm Hg, SD 9.9 mm Hg; P=.02) and diastolic blood pressure (baseline mean 89.4 mm Hg, SD 7.7 mm Hg; follow-up mean 82.5 mm Hg, SD 8.2 mm Hg; P<.001). On average, patients uploaded at least one blood pressure measurement on 75% (SD 25%) of study days. No improvements in medication adherence were noted. Interview data revealed areas of improvement and refinement for the patient experience. Furthermore, stakeholders require integration into the electronic health record and a modified clinical workflow for BPTrack to be truly useful; however, both patients and stakeholders perceived benefits of BPTrack when used within the context of a clinical relationship. Conclusions Results demonstrate that a pharmacist-led mHealth intervention promoting home blood pressure monitoring and clinical pharmacist management of hypertension can be effective at reducing blood pressure in primary care patients with uncontrolled hypertension. Our data also support the feasibility and acceptability of these types of interventions for patients and providers. Trial Registration ClinicalTrials.gov NCT02898584; https://clinicaltrials.gov/ct2/show/NCT02898584 International Registered Report Identifier (IRRID) RR2-10.2196/resprot.8059

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The Effectiveness of a Nurse-led Team-Based Hypertension Management among People with Uncontrolled Hypertension in a Community Hospital, Thailand

Jurnal NERS ◽

10.20473/jn.v16i2.28758 ◽

2021 ◽

Vol 16 (2) ◽

pp. 169

Author(s):

Nongnut Oba ◽

Navarat Chutipanyaporn

Keyword(s):

Blood Pressure ◽

Diastolic Blood Pressure ◽

Community Hospital ◽

Hospital Admissions ◽

Blood Pressure Monitoring ◽

Medication Administration ◽

Uncontrolled Hypertension ◽

Public Health Issue ◽

Hypertension Management ◽

Hypertensive Urgency

Introduction: Uncontrolled blood pressure of people with hypertension remains a major public health issue. The purpose of this research was to evaluate the effectiveness of a Nurse-led Team-based Hypertension Management Program (NTHMP) among people with uncontrolled hypertension.Methods: This quasi-experimental one-group pre-posttest design research was done to evaluate the effectiveness of a NTHMP in a community hospital in Thailand. The sample was thirty people with uncontrolled hypertension who received outpatient care in a community hospital in Thailand. They participated in three months NTHMP which included 1) team-approached health education, 2) medication administration support, 3) motivation interviewing on behavioral adjustment and 4) home blood pressure monitoring for three months. Outcomes of the program; systolic blood pressure, diastolic blood pressure, hospital admissions with signs of hypertensive urgency were analyzed by using frequency, percentage, mean, standard deviation, and repeated measured ANOVA.Results: The results indicated that people with uncontrolled HT had lower systolic blood pressures and diastolic blood pressure compared with baseline levels (p<0.001), and no hospital admissions.Conclusion: This program provided evidence for nurses to manage blood pressure control in people with hypertension within a collaboration with multidisciplinary team members in the community hospital.

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THE ERGONOMIC GYMNASTIC ON BLOOD PRESSURE AMONG ELDERLY

Nurse and Health: Jurnal Keperawatan ◽

10.36720/nhjk.v9i2.185 ◽

2020 ◽

Vol 9 (2) ◽

pp. 194-200

Author(s):

Yurike Septianingrum ◽

Moh Haris Susanto

Keyword(s):

Blood Pressure ◽

Blood Pressure Measurement ◽

Measurement Data ◽

Sampling Technique ◽

Simple Random Sampling ◽

Reduce Blood Pressure ◽

Uncontrolled Hypertension ◽

Rank Test ◽

P Value ◽

Before And After

Background: Pre elderly and elderly experience uncontrolled hypertension due to disobedience to diet and not regularly taking medication (Padila, 2013). Uncontrolled hypertension can cause stroke, heart trouble, coronary heart disease and death (Laily, 2017). One of the non-pharmacological therapies to reduce blood pressure elderly with hypertension is ergonomic gymnastic (Wratsongko, 2010).Objectives: The purpose of this study was to analyze the effect of ergonomic gymnastic on blood pressure among elderly.Methods: This study was pre-experimental with one-group pre-posttest design approaches. Population in this study were all elderly in Suko Village who matched the inclusion and exclusion criteria as many as 25 people. The sample of this study were 23 respondents and were taken by simple random sampling technique. Respondents were given ergonomic exercises for twice a week with a duration of 30 minutes. Blood pressure measurement data were taken using a sphygmomanometer and a stethoscope. Wilcoxon sign rank test with significance value less than .05 were used to analyzed data.Results: The results of the study there were significant differences between before and after doing ergonomic gymnastic with p value = 0.00, meaning that there was an influence of ergonomic gymnastics on blood pressure among elderly in Suko Village.Conclusion: The Ergonomic gymnastic can reduce blood pressure among elderly in Suko Village. The role of nurses is needed as a provider of geriatric nursing care, especially in hypertension geriatric Keywords: Hypertension, Ergonomic Gymnastic, Elderly, Blood Pressure.

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Hubungan Pengetahuan Dengan Sikap Ibu dalam Pemberian ASI Eksklusif di Wilayah Kerja Puskesmas Pranggang Kabupaten Kediri

Jurnal Ilmu Kesehatan ◽

10.32831/jik.v3i1.39 ◽

2017 ◽

Vol 3 (1) ◽

pp. 1

Author(s):

Triatmi Andri Yanuarini ◽

Dwi Estuning Rahayu ◽

Ekanana Prahitasari

Keyword(s):

Public Health ◽

Breast Feeding ◽

Exclusive Breastfeeding ◽

Sampling Technique ◽

Health Department ◽

Rank Test ◽

Cluster Sampling ◽

Cross Sectional ◽

Significance Level ◽

Knowledge And Attitude

Exclusive breastfeeding is breast-feeding for 6 months without any additional liquid. According to Health Department of Kabupaten Kediri in 2013, the exclusive breastfeeding program’s achievement is 57.2%. The lowest or the worst achievement of exclusive breastfeeding in Kediri is in Public Health center of Pranggang, it is 5.4%. The purpose of this study is to identify and analyze the correlation between mother’s knowledge and attitude in giving exclusive breastfeeding at territorial of Public Health in Pranggang - Kediri. The method which used in this study was the correlation of analytical studies using cross-sectional approach. The population of this study were all 54 breastfeeding mothers of babies aged 0-6 months in Pranggang, Punjul and Sumber Agung. The sampling technique in this study was the probability sampling with cluster sampling method. The samples in this study were 48 respondents. The results of the 48 respondents, 36 people (75%) had good breastfeeding. Statistical analysis of the data using the Spearman Rank test with a significance level of 0,05 and df = 46, it is obtained (5,694) ; t table (2,021). It shows that there is correlation between mother’s knowledge and attitude in giving exclusive breastfeeding for babies in age 0-6 months at territorial of Public Health in Pranggang. The writer hopes the midwifery will give motivation more to the mothers for giving exclusive breast-feeding.; Key words: Knowledge, Mother’s Attitude, Exclusive breastfeeding

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Understanding the Feasibility, Acceptability, and Efficacy of a Clinical Pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: Mixed Methods Pilot Study (Preprint)

10.2196/preprints.19882 ◽

2020 ◽

Author(s):

Lorraine R Buis ◽

Dana N Roberson ◽

Reema Kadri ◽

Nicole G Rockey ◽

Melissa A Plegue ◽

...

Keyword(s):

Blood Pressure ◽

Pilot Study ◽

Clinical Pharmacist ◽

Blood Pressure Monitoring ◽

Home Blood Pressure ◽

Uncontrolled Hypertension ◽

Hypertension Management ◽

Home Blood Pressure Monitoring ◽

Pressure Monitoring

BACKGROUND Hypertension is a prevalent and costly burden in the United States. Clinical pharmacists within care teams provide effective management of hypertension, as does home blood pressure monitoring; however, concerns about data quality and latency are widespread. One approach to close the gap between clinical pharmacist intervention and home blood pressure monitoring is the use of mobile health (mHealth) technology. OBJECTIVE We sought to investigate the feasibility, acceptability, and preliminary effectiveness of BPTrack, a clinical pharmacist-led intervention that incorporates patient- and clinician-facing apps to make electronically collected, patient-generated data available to providers in real time for hypertension management. The patient app also included customizable daily medication reminders and educational messages. Additionally, this study sought to understand barriers to adoption and areas for improvement identified by key stakeholders, so more widespread use of such interventions may be achieved. METHODS We conducted a mixed methods pilot study of BPTrack, to improve blood pressure control in patients with uncontrolled hypertension through a 12-week pre-post intervention. All patients were recruited from a primary care setting where they worked with a clinical pharmacist for hypertension management. Participants completed a baseline visit, then spent 12 weeks utilizing BPTrack before returning to the clinic for follow-up. Collected data from patient participants included surveys pre- and postintervention, clinical measures (for establishing effectiveness, with the primary outcome being a change in blood pressure and the secondary outcome being a change in medication adherence), utilization of the BPTrack app, interviews at follow-up, and chart review. We also conducted interviews with key stakeholders. RESULTS A total of 15 patient participants were included (13 remained through follow-up for an 86.7% retention rate) in a single group, pre-post assessment pilot study. Data supported the hypothesis that BPTrack was feasible and acceptable for use by patient and provider participants and was effective at reducing patient blood pressure. At the 12-week follow-up, patients exhibited significant reductions in both systolic blood pressure (baseline mean 137.3 mm Hg, SD 11.1 mm Hg; follow-up mean 131.0 mm Hg, SD 9.9 mm Hg; <i>P</i>=.02) and diastolic blood pressure (baseline mean 89.4 mm Hg, SD 7.7 mm Hg; follow-up mean 82.5 mm Hg, SD 8.2 mm Hg; <i>P</i><.001). On average, patients uploaded at least one blood pressure measurement on 75% (SD 25%) of study days. No improvements in medication adherence were noted. Interview data revealed areas of improvement and refinement for the patient experience. Furthermore, stakeholders require integration into the electronic health record and a modified clinical workflow for BPTrack to be truly useful; however, both patients and stakeholders perceived benefits of BPTrack when used within the context of a clinical relationship. CONCLUSIONS Results demonstrate that a pharmacist-led mHealth intervention promoting home blood pressure monitoring and clinical pharmacist management of hypertension can be effective at reducing blood pressure in primary care patients with uncontrolled hypertension. Our data also support the feasibility and acceptability of these types of interventions for patients and providers. CLINICALTRIAL ClinicalTrials.gov NCT02898584; https://clinicaltrials.gov/ct2/show/NCT02898584 INTERNATIONAL REGISTERED REPORT RR2-10.2196/resprot.8059

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Device therapy of resistant hypertension

Orvosi Hetilap ◽

10.1556/oh.2013.29543 ◽

2013 ◽

Vol 154 (6) ◽

pp. 203-208 ◽

Cited By ~ 1

Author(s):

Gábor Simonyi ◽

J. Róbert Bedros ◽

Mihály Medvegy

Keyword(s):

Blood Pressure ◽

Cardiovascular Risk ◽

Resistant Hypertension ◽

Carotid Sinus ◽

Maximum Tolerated Dose ◽

Reduce Blood Pressure ◽

Nerve Fibers ◽

Uncontrolled Hypertension ◽

Sympathetic Nerve Fibers ◽

Treatment Of Hypertension

It is well known that hypertension is an independent cardiovascular risk factor. Treatment of hypertension frequently includes administration of three or more drugs. Resistant hypertension is defined when blood pressure remains above target value despite full doses (the patient’s maximum tolerated dose) of antihypertensive medication consisting of at least three different classes of drugs including a diuretic. Pharmacological treatment of hypertension is often unsuccessful despite the increasing number of drug combinations. Uncontrolled hypertension, however, increases the cardiovascular risk. Device treatment of resistant hypertension is currently testing two major fields. One of them the stimulation of baroreceptors in the carotid sinus and the other is radiofrequency ablation of sympathetic nerve fibers around renal arteries to reduce blood pressure in drug resistant hypertension. Orv. Hetil., 2013, 154, 203–208.

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