Effects Of Medication Self-efficacy Intervention On Blood Pressure In Community Patients With Essential Hypertension

Objective:To study the effect of medication self-efficacy intervention of community patients with essential hypertension on the medication self-efficacy and to explore the effect of medication self-efficacy intervention on blood pressure in community hypertension patients; to offer reference for the drug management in community.Methods:The study was a non-randomized trial conducted in Yongchang Community Health Station in Changchun between June 2010 and December 2010. A total of 72 participants with essential hypertension were recruited.During this study period,2 patients were out and 5 patients were quit, eventually a total of 65 patients finished the intervention.Chinese version of Medication Adherence Self-Efficacy Scale (MASES) was used to measure participants'medication self-efficacy and blood pressure was taken each month during intervention. The health education was designed with self-efficacy theory as a framework, such as lectures (including six subjects), providing role models, psychological support, medication reminder and follow-up. Data were analyzed by SPSS13.0 software. The methods of descriptive analysis, analysis of variance and chi-square test were used to process data.Results:1.Medication Self-Efficacy improvement after interventionMASES score was 84.98±3.95 at baseline,86.75±3.44 at one month and 93.02±2.39 after the 6-month intervention(F=328.701,P<0.05)。2.Participants'some characteristics affecting Medication Self-Efficacy increasingMASES score increasing was not significantly observed in participants with different gender, age, occupation status, source of medication and living style (P>0.05).And MASES increasing was significantly found in participants with different marital status, education background, income, hypertension duration, complications and kinds of medication (P<0.05).3. Blood pressure under control after interventionAfter six-month intervention, the mean change was a decrease of 7.32±5.26 mmHg in SBP and 4.98±2.98 mmHg in DBP. Difference in SBP of participants was significantly observed among 149.57±9.38 mmHg at baseline,148.74±10.15 mmHg after one month,145.57±8.40 mmHg after 3 months and 142.25±7.80 mmHg aftert 6 months (F=76.877, P<0.05). Difference in DBP of participants was significantly observed among 91.23±4.70 mmHg at baseline,90.34±5.42 mmHg aftert one month 88.06±4.78mmHg aftert 3 months and 86.25±4.22 mmHg aftert 6 months (F=105.206, P<0.05).The rate of hypertension controlling was 26.15%aftert one month,27.69% after 3 months and 50.77% after 6 months (x2= 10.884, P<0.05).After intervention, SBP reduciton was significantly observed in participants with different age and occupation status(P<0.05).And DBP reduction was not significantly different in participants with different characteristics (P>0.05).After one month intervention,17 of the participants(26.15%) with different self-efficacy had the blood pressure under control and after 6 months,33 participants (50.77%) had their blood pressure under control.Conclusions:1.Medication self-efficacy intervention can effectively improve the level of medication self-efficacy in community hypertension patients.2.Improvement of medication self-efficacy was associated with some participants'characteristics, such as education background, income, disease duration.3.Medication self-efficacy intervention can make the blood pressure of patients with hypertension under control.4.Level of Medication self-efficacy can affect the rate of hypertension under control.