EFFECT OF A PHARMACIST INTERVENTION ON SELF MANAGEMENT PRACTICES AMONG HYPERTENSIVE-DIABETIC PATIENTS RECEIVING CARE IN A NIGERIAN TERTIARY HOSPITAL
DOI:
https://doi.org/10.22159/ijpps.2021v13i5.40987Keywords:
Hypertension, Self-management practices, Blood pressure control, Pharmacist interventionAbstract
Objective: The objective of this study was to evaluate the effect of a pharmacist-led intervention on self-management practices among hypertensive-diabetic patients receiving care in a Nigeria tertiary hospital.
Methods: The study adopted a prospective, longitudinal; single-blind, two-arm randomised controlled trial to implement a pharmacist-led educational intervention on hypertension management among patients in Federal Medical Centre Lokoja, Kogi State. All the patients who met the eligibility criteria and gave their written consent to participate in the study were recruited into the study randomized in the intervention group (IG) and Control (CG). Data was collected using Hypertension Self Care Activity Level Effects (H-SCALE) questionnaire. The retrieved questionnaires were first coded into Microsoft Excel (2014) for cleaning of errors, after which the data was exported into the Statistical Product and Services Solutions (SPSS for windows, Version 16.0. SPSS Inc. 2007, Chicago, USA) software. Descriptive statistics such as frequencies, percentages and mean scores were used to summarise the data. All responses were first presented as frequencies and percentages. Chi-square was used to determine the correlation between socio-demographic and patients’ clinical characteristics. Independent sample t-test and paired sample t-test were used to compare differences between and within groups.
Results: At baseline, more patients in the control group were adherent to their medications 16 (11.5) and had low salt diets 47 (33.8) than patients in the intervention group. However, more patients in the intervention group were non-smokers 127 (88.8) and engaged more in physical activity 38 (26.6) than patients in the control group. However, more of the patients in the control group were adherent to weight management practices 38 (27.3) than patients in the intervention group 36 (25.2), at baseline. All the patients in both study groups reported to have taken alcohol in the past seven days. It can be seen that, patients in the intervention group at endpoint, differed positively from the control group at baseline in adherence to medication, physical activity, reducing alcohol consumption and smoking cessation. It can also be observed that the baseline intervention group differed positively from the endpoint in medication adherence (t=-26.045, p<0.001); physical activity (t=-15.081, p<0.001); weight management practices (t=-5.479, p<0.0010, and alcohol consumption 9t=-11.550, p<0.001).
Conclusion: A pharmacist led educational intervention had a positive impact on the self-management practices of hypertensive-diabetes patients.
Downloads
References
Ogah OS, Okpechi I, Chukwuonye II, Akinyemi JO, Onwubere BJC, Falase A. Blood pressure, prevalence of hypertension and hypertension-related complications in Nigeria: a review. World J Cardiol 2012;4:327–40.
Black J, Hawks J. Medical-surgical nursing. In: Clinical management for positive outcomes. 7th ed. St. louis, Mo: Elsevier Saunders; 2005.
US Department of Health and Human Services. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. In: National Institutes of Health; 2004.
Dickinson HO, Mason JM, Nicolson DJ, Campbell F. Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized control trials. J Hypertens 2006; 24:216–33.
Svetkey LP, Harsha DW, Vollmer WM, Stevens VJ. A clinical trial of comprehensive lifestyle modification for blood pressure control: rationale, design and baseline characteristics. Ann Epidemiol 2003;13:462–71.
Weir MR, Maibach EW, Bakris GL, Black HR. Implications of a health lifestyle and medication analysis for improving hypertension control. Archael Intern Med 2000;160:481–90.
Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the international society of hypertension. J Clin Hypertens 2014;16:14–36.
He FJ, MacGregor GA. How far should salt intake be reduced? Hypertension 2003;42:1093–9.
World Health Organisation. Diet, nutrition and the prevention of chronic disease. Report of a Joint WHO/FAO Expert Consultation. WHO; 2003.
Dickinson HO, Mason JM, Nicolson DJ, Campbell F, Beyer FR, Cook JV. Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials. J Hypertens 2006;24:215–33.
Strazzullo P, D’Elia L, Kandala NB, Cappuccio FP. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. Br Med J 2009;339:456.
Graudal NA, Hubeck Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev 2011;11:CD004022.
Veronique AC, Neil A. Exercise training for blood pressure: a systematic review and metaanalysis. J Am Hear Assoc 2013;41:44–57.
Rossi A, Dikareva A, Bacon SL, Daskalopoulou SS. The impact of physical activity on mortality in patients with high blood pressure: a systematic review. J Hypertens 2012;30:1277–88.
Fagard RH. Exercise therapy in hypertensive cardiovascular disease. Progress Cardiovasc Dis 2011;53:404–11.
Pescatello LS. Exercise and hypertension: recent advances in exercise prescription. Curr Hypertens Repos 2005;7:281–6.
Virdis A. Cigarette smoking and hypertension. JAMA 2010;12:56–68.
Li G, Wang H, Wang K. The association between smoking and blood preesure in men: A cross-sectional study. BMC Public Health 2017;17:797.
Halperin RO, Gaziano JM, Sesso HD. Smoking and the risk of incident hypertension in midle-aged and older men. Am J Hypertens 2008;21:148–52.
Thuy AB, Blizzard L, Schmidt MD, Luc PH, Granger RH, Dwyer T. The association between smoking and hypertension in a population-based sample of vietnamese men. J Hypertens 2010;28:245–50.
Cavusoglu Y, Timurralp B, Us T, Akgun Y, Kudaiberdieva G, Gorenek B, et al. Cigarette smoking increases plasma concentrations of vascular cell adhesion molecule-1 in patients with coronary artery disease. Angiology 2004;55:397–402.
Berlin I, Cournot A, Renout P, Duchier J, Safar M. Peripheral haemodynamic effects of smoking in habitual smokers: a methodological study. Eur J Clin Pharmacol 1990;38:57–60.