scholarly journals A Web-Based Self-Titration Program to Control Blood Pressure in Patients With Primary Hypertension: Randomized Controlled Trial

10.2196/15836 ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. e15836 ◽  
Author(s):  
Chi-Wen Kao ◽  
Ting-Yu Chen ◽  
Shu-Meng Cheng ◽  
Wei-Shiang Lin ◽  
Yue-Cune Chang
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Intervention Group ◽  
Primary Hypertension ◽  
Control Group ◽  
Health Related Quality ◽  
Web Based ◽  
Related Quality ◽  
Health Related

Background Hypertension is a major cause of mortality in cardiac, vascular, and renal disease. Effective control of elevated blood pressure has been shown to reduce target organ damage. A Web-based self-titration program may empower patients to control their own disease, share decisions about antihypertensive dose titration, and improve self-management, ultimately improving health-related quality of life. Objective Our primary aim was to evaluate the effects of a Web-based self-titration program for improving blood pressure control in patients with primary hypertension. Our secondary aim was to evaluate the effects of that program on improving health-related quality of life. Methods This was a parallel-group, double-blind, randomized controlled trial with assessments at baseline, 3 months, and 6 months. We included patients with primary hypertension (blood pressure>130/80 mm Hg) from a cardiology outpatient department in northern Taiwan and divided them randomly into intervention and control groups. The intervention group received the Web-based self-titration program, while the control group received usual care. The random allocation was concealed from participants and outcome evaluators. Health-related quality of life was measured by the EuroQol five-dimension self-report questionnaire. We used generalized estimating equations to evaluate the effects of the intervention. Results We included 222 patients and divided them equally into intervention (n=111) and control (n=111) groups. Patients receiving the Web-based self-titration program showed significantly greater improvement in the systolic and diastolic blood pressure control than those who did not receive this program, at 3 months (–21.4 mm Hg and –5.4 mm Hg, respectively; P<.001) and 6 months (–27.8 mm Hg and –9.7 mm Hg, respectively; P<.001). Compared with the control group, the intervention group showed a significant decrease in the overall defined daily dose at both 3 (–0.202, P=.003) and 6 (–0.236, P=.001) months. Finally, health-related quality of life improved significantly in the intervention group compared with the control group at both 3 and 6 months (both, P<.001). Conclusions A Web-based self-titration program can provide immediate feedback to patients about how to control their blood pressure and manage their disease at home. This program not only decreases mean blood pressure but also increases health-related quality of life in patients with primary hypertension. Trial Registration ClinicalTrials.gov NCT03470974; https://clinicaltrials.gov/ct2/show/NCT03470974

scholarly journals A Web-Based Self-Titration Program to Control Blood Pressure in Patients With Primary Hypertension: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Chi-Wen Kao ◽  
Ting-Yu Chen ◽  
Shu-Meng Cheng ◽  
Wei-Shiang Lin ◽  
Yue-Cune Chang
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Intervention Group ◽  
Primary Hypertension ◽  
Control Group ◽  
Health Related Quality ◽  
Web Based ◽  
Related Quality ◽  
Health Related

BACKGROUND Hypertension is a major cause of mortality in cardiac, vascular, and renal disease. Effective control of elevated blood pressure has been shown to reduce target organ damage. A Web-based self-titration program may empower patients to control their own disease, share decisions about antihypertensive dose titration, and improve self-management, ultimately improving health-related quality of life. OBJECTIVE Our primary aim was to evaluate the effects of a Web-based self-titration program for improving blood pressure control in patients with primary hypertension. Our secondary aim was to evaluate the effects of that program on improving health-related quality of life. METHODS This was a parallel-group, double-blind, randomized controlled trial with assessments at baseline, 3 months, and 6 months. We included patients with primary hypertension (blood pressure&gt;130/80 mm Hg) from a cardiology outpatient department in northern Taiwan and divided them randomly into intervention and control groups. The intervention group received the Web-based self-titration program, while the control group received usual care. The random allocation was concealed from participants and outcome evaluators. Health-related quality of life was measured by the EuroQol five-dimension self-report questionnaire. We used generalized estimating equations to evaluate the effects of the intervention. RESULTS We included 222 patients and divided them equally into intervention (n=111) and control (n=111) groups. Patients receiving the Web-based self-titration program showed significantly greater improvement in the systolic and diastolic blood pressure control than those who did not receive this program, at 3 months (–21.4 mm Hg and –5.4 mm Hg, respectively; <italic>P</italic>&lt;.001) and 6 months (–27.8 mm Hg and –9.7 mm Hg, respectively; <italic>P</italic>&lt;.001). Compared with the control group, the intervention group showed a significant decrease in the overall defined daily dose at both 3 (–0.202, <italic>P</italic>=.003) and 6 (–0.236, <italic>P</italic>=.001) months. Finally, health-related quality of life improved significantly in the intervention group compared with the control group at both 3 and 6 months (both, <italic>P</italic>&lt;.001). CONCLUSIONS A Web-based self-titration program can provide immediate feedback to patients about how to control their blood pressure and manage their disease at home. This program not only decreases mean blood pressure but also increases health-related quality of life in patients with primary hypertension. CLINICALTRIAL ClinicalTrials.gov NCT03470974; https://clinicaltrials.gov/ct2/show/NCT03470974

scholarly journals MediYoga as a part of a self-management programme among patients with paroxysmal atrial fibrillation – a randomised study

2019 ◽  
Vol 19 (1) ◽  
pp. 74-82 ◽  
Author(s):  
Maria Wahlström ◽  
Mårten Rosenqvist ◽  
Jörgen Medin ◽  
Ulla Walfridsson ◽  
Monica Rydell-Karlsson
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Heart Rate ◽  
Paroxysmal Atrial Fibrillation ◽  
Control Group ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Background: Paroxysmal atrial fibrillation is associated with impaired health-related quality of life. Yoga has been suggested to improve health-related quality of life among patients with heart failure and hypertension. Aim: The aim of the study was to evaluate the effects of MediYoga, in respect of health-related quality of life, blood pressure, heart rate, as well as N-terminal pro b-type natriuretic peptide, among patients with symptomatic paroxysmal atrial fibrillation, compared with standard therapy or relaxation. Methods: Patients with symptomatic paroxysmal atrial fibrillation, n=132, were stratified for gender and randomised to MediYoga, a relaxation group or a control group, 44 patients per group with a 12-week follow-up. Health-related quality of life, blood pressure, heart rate and N-terminal pro b-type natriuretic peptide were assessed. Results: After 12 weeks, there were no differences in health-related quality of life between the groups. There were improvements in Short-Form Health Survey bodily pain, general health, social function, mental health and mental component summary scores within the MediYoga group ( p=0.014, p=0.037, p=0.029, p=0.030, p=0.019, respectively). No change was seen in the relaxation and control groups. Systolic blood pressure decreased in the MediYoga group (134±18 to 127±13) compared with the control group (126±17 to 127±15, p=0.041); no difference compared with the relaxation group (131±17 to 125±12). Diastolic blood pressure decreased in the MediYoga group (79±9 to 74 ±9) compared with the control group (76±9 to 79±8, p=0.005); no difference compared with the relaxation group (76±9 to 77±8). There were no differences in heart rate and N-terminal pro b-type natriuretic peptide between the groups after 12 weeks. Conclusions: MediYoga improves health-related quality of life and decreases blood pressure in patients with paroxysmal atrial fibrillation. MediYoga may be used as a part of a self-management programme among patients with paroxysmal atrial fibrillation.

Effects of a nine-month occupational intervention on health-related quality of life

2017 ◽  
Vol 45 (4) ◽  
pp. 452-458
Author(s):  
Birgitta Ojala ◽  
Clas-Håkan Nygård ◽  
Heini Huhtala ◽  
Seppo T. Nikkari
Keyword(s):  
Quality Of Life ◽  
Intervention Group ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Base Line ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

The aim of this study was to evaluate the effectiveness of vocationally outpatient oriented rehabilitation on an intervention group, compared with a control group that did not take part in the intervention. The groups were compared for health-related quality of life (HRQoL) by the quantitative indicator RAND 36. Data were obtained by a self-report at baseline and at nine months follow-up. Differences between base-line and follow-up were analyzed within group and between the groups. The study population consisted of 751 municipal employees aged between 26 and 64 years; an intervention with 463 women and 115 men ( n = 578), and a control group with 138 women and 35 men ( n = 173). In this study we focused on those who had answered to all questions in RAND 36, thus 581 remained. Of these, 388 were in the intervention group (mean age 49.0 years) and 110 in the control group (mean age 48.4 years). Intervention was based on cognitive behavioral therapy. Participants in the 9-month outpatient intervention group showed statistically significant increase in all eight RAND 36 areas. Most improvement was seen in the psychosocial functioning index ( p = 0.002). Although there were no statistically significant changes in RAND 36 components in the control group, difference in changes between groups were seen in energy and fatigue ( p < 0.001), social functioning ( p = 0.032) and general health perceptions 0.027 in favor of the intervention group. The results suggest that a cognitive behavioral intervention as an early rehabilitation program is effective in increasing employees’ quality of life, as measured by RAND 36.

scholarly journals Improvements in health-related quality of life and function in middle-aged women with chronic diseases of lifestyle after participating in a non-pharmacological intervention programme: A pragmatic randomised controlled trial

2019 ◽  
Vol 8 ◽  
Author(s):  
Roline Y. Barnes ◽  
Jennifer Jelsma ◽  
Romy Parker
Keyword(s):  
Quality Of Life ◽  
Chronic Diseases ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Randomised Controlled

Background: Musculoskeletal diseases consume a large amount of health and social resources and are a major cause of disability in both low- and high-income countries. In addition, patients frequently present with co-morbid chronic diseases of lifestyle. The area of musculoskeletal disease is restricted by a lack of epidemiological knowledge, particularly in low- and middle-income countries.Objectives: This pragmatic randomised controlled trial assessed the benefits of a 6-week physiotherapy intervention for middle-aged women with musculoskeletal conditions compared to usual care.Method: A weekly 2-h educational programme utilising a workbook, discussion group and exercise class was presented for the intervention group, while the control group received usual care. The primary outcome was health-related quality of life. Parametric and non-parametric data were used to determine the equivalence between the groups.Results: Twenty-two participants were randomised to the intervention and 20 to the control group. The control group demonstrated no within-group improvement in health-related quality of life items, compared to significant improvements in two items in the intervention group. The change in median utility score within the intervention group was twice as large as the change in the control group. With regard to self-efficacy, the intervention group demonstrated significant within-group changes in perceived management of fatigue and discomfort.Conclusion: The positive impact of the intervention on the participants suggests that the programme should continue at the clinic in question, but should be presented at a more convenient time for participants who work, as recruitment to the study was less than anticipated. Primary health care systems in South Africa urgently need to put structures in place for effective management of the functional impact of chronic diseases of lifestyle and musculoskeletal conditions. It is time for physiotherapists and possibly other health care professionals to participate in the development of appropriate community level interventions to address the functioning and quality of life of individuals living with the diseases.

scholarly journals Jaw exercise therapy for the treatment of trismus in head and neck Cancer: a prospective three-year follow-up study

2020 ◽  
Author(s):  
Ove Karlsson ◽  
Therese Karlsson ◽  
Nina Pauli ◽  
Paulin Andréll ◽  
Caterina Finizia
Keyword(s):  
Quality Of Life ◽  
Exercise Therapy ◽  
Intervention Group ◽  
Control Group ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Eortc Qlq

Abstract Purpose This study aims to examine effects of jaw exercise on trismus 3 years following completion of a post-radiotherapy jaw exercise intervention. Methods Prospective study including 50 patients with head-and-neck cancer receiving radiotherapy and/or chemotherapy, plus a matched control group. The intervention group underwent 10 weeks of jaw exercise training. Patients were followed pre-and postintervention and 3 years postintervention completion. Outcome measures were maximal interincisal opening (MIO), trismus-related symptoms, and health-related quality-of-life as measured by Gothenburg Trismus Questionnaire, EORTC QLQ-C30, and EORTC QLQ-H&N35. Results The intervention group had a statistically significantly higher mean MIO compared with the control group (40.1 mm and 33.9 mm, respectively, p < 0.001), reported less trismus-related problems and had an improved health-related quality-of-life when compared with the control group at the 3-year follow-up. These differences were all statistically significant. Conclusion Jaw exercise therapy resulted in increased MIO, less trismus-related symptoms, and improved health-related quality-of-life. Jaw exercise therapy should be initiated early, in a structured manner and continued long-term.

scholarly journals Pharmacist’s Intervention on Pill Burden Effects on the Health-Related Quality of Life of Elderly Diabetic Patients in a Tertiary Hospital in Southwestern Nigeria

2019 ◽  
Vol 25 (3-4) ◽  
pp. 148-154
Author(s):  
Winifred Aitalegbe Ojieabu
Keyword(s):  
Quality Of Life ◽  
Physical Functioning ◽  
Intervention Group ◽  
Control Group ◽  
Diabetic Patients ◽  
Pill Burden ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

<b><i>Background:</i></b> Diabetes and its associated complications take a toll on the elderly. It is known that medication burden could reduce patients’ adherence, which in turn impacts negatively on the health-related quality of life (HRQOL) of those suffering from chronic diseases. Studies have been conducted on HRQOL and its associated factors among diabetic patients but none has studied pill burden effects on HRQOL. This research evaluated pharmacist’s intervention on pill burden effects on the HRQOL of elderly diabetic patients. <b><i>Methods:</i></b> This 8-month randomized controlled study involved 170 elderly type 2 diabetic patients. Socio-demographics, the impact of the number and dosage frequency of drugs on adherence, and the influence of the pill burden on HRQOL scores were evaluated at baseline and at 4 and 8 months. Patients in the intervention group were educated about diabetes and its management and counselled on treatment adherence. Brisk walking was specially demonstrated to them at least 4 times during the study period. The control group received only the usual call reminders for appointment days. <b><i>Results:</i></b> At baseline, 58.8 and 64.7%, respectively, in the control and intervention groups responded “yes” (indicating a negative effect on their adherence) to &#x3e;5 pills per prescription, while the figures were 55.3 and 15.3%, respectively, at 8 months (<i>p</i> = 0.711 and <i>p</i> = 0.000, respectively). Patients on 1–5 pills per prescription in the control group had the following physical functioning scores: baseline (44.2 ± 14.2) versus 4 months (47.2 ± 19.1) and 8 months (47.7 ± 16.1); <i>p</i> = 0.277 and <i>p</i> = 0.160. The physical functioning scores in the intervention group were: baseline (41.7 ± 16.1) versus 4 months (67.6 ± 23.1) and 8 months (92.5 ± 3.5); <i>p</i> ≤ 0.001. The same pattern of results was found for those on &#x3e;5 pills per prescription. <b><i>Conclusion:</i></b> This study demonstrates pharmacists’ ability to improve the HRQOL of patients through continuous counselling, supply of relevant information, and monitoring of drug, exercise, and diet adherence. Intervention such as this could be beneficial to diabetic patients and others with chronic diseases.

scholarly journals Effect of the Wii Sports Resort on Mobility and Health-Related Quality of Life in Moderate Stroke

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Iratxe Unibaso-Markaida ◽  
Ioseba Iraurgi
Keyword(s):  
Quality Of Life ◽  
Daily Life ◽  
Intervention Group ◽  
Effect Sizes ◽  
Control Group ◽  
Health Related Quality ◽  
Daily Life Activities ◽  
Related Quality ◽  
Health Related

Background. Stroke is a common cerebral circulatory disorder that has several sequelae that affect the daily life of patients as well as their quality of life and the lives of people close to them. Video games are being used in the rehabilitation process to address these sequelae and their benefits are shown on physical activity and in the cognition area. However, their effects on daily life activities and quality of life are not known. This study was aimed to test the effect of the Nintendo Wii Sports Resort on mobility and health-related quality of life among patients who have suffered a moderate stroke. Methods. A prepost design study was conducted with 30 moderately impaired stroke patients aged 65 ± 15 . The study lasted eight weeks. 15 participated in the intervention group and the others belong to the control group. They were assessed in mobility (Timed Get Up and Go Test—TUG) and health-related quality of life (SF-36 Health Questionnaire). Parametric test and effect sizes were used to analyze the change in outcomes and to compare groups. Results. There were no differences at baseline between the groups. After the intervention, the intervention group had experienced a greater change according to the size of the effect on the variables concerning TUG ( d = 1.32 ), physical function ( d = 1.32 ), social function ( d = 0.71 ), and Physical Component Summary ( d = 0.75 ). On the other hand, the control group had a significant change in mental health according to effect size; however, this effect is not statistically relevant ( d = 0.88 ; CI   95 % = − 3.74   to   5.50 ). Conclusions. The results on mobility and health-related quality of life indicate an improvement in both groups. However, according to the effect sizes and its confidence of interval, the intervention group achieved better results than the control group. Although more studies are needed in this area, the results are encouraging for improving mobility and health-related quality of life after stroke.

Oral Health-Related Quality of Life Among Sudanese Children Treated for Cleft Lip and Palate

2021 ◽  
pp. 105566562098769
Author(s):  
Mecheala Abbas Ali ◽  
Alwaleed Fadul Nasir ◽  
Shaza K. Abass
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Arabic Version ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Objective: This study compared the oral health-related quality of life (OHRQoL) among children with a cleft lip with or without a cleft palate (CL±P) and a group of their peers. The reliability of the Arabic version of the Child Oral Health Impact Profile Questionnaire (COHIP) was also assessed. Design: A cross-sectional study. Settings: Cleft clinic in a private dental college in Omdurman City, Sudan. Patients: In all, 75 children (mean age 11.3 ± 2.5 years) with a history of CL±P and a group of 150 school children without CL±P (mean age 11.4 ± 2.6 years). Main Outcome Measures: Overall and subscale scores on the Arabic version of the COHIP. Results: Test–retest reliability of COHIP in Arabic was high with an interclass correlation coefficient >0.8. Cronbach α value internal consistency was 0.8 for the total scale and between 0.7 and 0.8 for the subscales. The COHIP score was 89.41 ± 19.97 in children with CL±P and 122.82 ± 9.45 for the control group. Children with CL±P had significantly lower scores on the overall and all subscales when compared to children without CL±P ( P ≤ .001). Among the children with CL±P, there were no statistically significant differences on the COHIP based on age and/or gender ( P ≥ .05). Conclusions: Children with CL±P had a relatively high OHRQoL, which was lower than that of their peers without CL±P in both the overall scale and all subscales. Gender and age differences had no significant impact on the OHRQoL. The COHIP Arabic version showed appropriate reliability.

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