A WeChat-Based Self-Management Intervention for Community Middle-Aged and Elderly Adults with Hypertension in Guangzhou, China: A Cluster-Randomized Controlled Trial.

Li Li,Chen Chen,Lin Lin,An An,Xie Xie,Lv Lv

doi:10.3390/ijerph16214058

Abstract

This study aimed to assess whether a WeChat-based self-management intervention would be effective for community middle-aged and elderly adults with hypertension in Guangzhou, China. We conducted a cluster-randomized control trial with a total of 464 participants (intervention, n = 186; control, n = 276) between March 2018 and May 2019. The self-management intervention lasted for 6 months, consisting of health education, health promotion, group chat, and blood pressure (BP) monitoring. All individuals in the baseline and follow-up surveys were assessed for BP and completed a hypertension knowledge questionnaire, self-efficacy scale, self-management scale, and social support scale. A total of 253 participants (intervention, n = 110; control, n = 143) completed the follow-up survey and were included in the analysis. The adjusted mean differences in the changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the intervention and control groups were −6.9 (95% Confidence Interval (CI) −11.2 to −2.6; p = 0.002) and −3.1 (95% CI −5.7 to −0.6; p = 0.016) mmHg, respectively. Individuals who participated in the intervention program had better BP monitoring, improved their hypertension self-management as well as parts of their disease knowledge and self-efficacy. The WeChat-based self-management intervention may be a feasible and efficient program to help Chinese community middle-aged and elderly hypertensive patients lower BP and improve self-management.

Highlights

Hypertension has become one of the most important causes of disease burden worldwide, as it is considered the leading risk factor for cardiovascular diseases [1]
Individuals who were WeChat users, who were aged 45–70 years, who had lived in the community for at least six months, who reported a definite diagnosis of hypertension while taking or having ever taken antihypertensive drugs, and who were willing to participate in our study were eligible for recruitment
blood pressure (BP) changed significantly in the intervention group compared to the control group: differences in adjusted mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) changes were −6.9 and

Summary

Introduction

Hypertension has become one of the most important causes of disease burden worldwide, as it is considered the leading risk factor for cardiovascular diseases [1]. In China, high systolic blood pressure (SBP) was the top risk factor for the number of deaths in 2017 [2], accounting for 2.54 million deaths. The latest China Hypertension Survey [3] showed that the prevalence rate of hypertension was rising rapidly, and 23.2% of adults (at least 18 years of age) had hypertension. Despite the rate of hypertension control rising from 6.1% (2002) to 16.8% (2015) [4], it is still at a low level. Improving self-management (e.g., increasing medication adherence, enhancing monitoring blood pressure (BP), and reducing salt intake) is an effective way [5] to reduce BP, but most patients’. Public Health 2019, 16, 4058; doi:10.3390/ijerph16214058 www.mdpi.com/journal/ijerph

Objectives

Methods

Results

Conclusion