Effect of a nurse-led hypertension management program on quality of life, medication adherence and hypertension management in older adults: A randomized controlled trial.

Abstract

This study evaluated the effects of a nurse-led hypertension management program on quality of life, medication adherence and hypertension management in older adults. A total of 74 hypertensive older adults residing in two different nursing homes were randomized to the intervention group (n = 37) or control group (n = 37). The intervention group participated in a training program consisting of 20 weeks of health education and motivational meetings. Data were collected using a hypertension management knowledge and behavior questionnaire, quality of life scale, Morisky Medication Adherence Scale, and measurements of blood pressure and anthropometric and biochemical parameters. Data were analyzed using the χ2 -test, Wilcoxon signed-rank test and Mann-Whitney U-test. Post-test systolic (118.64 ± 10.04 mmHg) and diastolic (77.83 ± 5.34 mmHg) blood pressures, and total cholesterol levels (178.43 ± 25.59 mg/dL) were significantly lower in the intervention group compared with the control group (130.54 ± 15.08 mmHg, 82.70 ± 7.69 mmHg, 200.7 ± 34.57 mg/dL, respectively). Post-test hypertension knowledge score (20.75 ± 1.01), medication adherence rate (100.0%), and quality of life scale physical component (58.42 ± 13.93) and mental component (64.24 ± 12.85) scores were significantly higher in the intervention group than in the control group (12.21 ± 2.48; 64.9%; 44.36 ± 16.73; 53.93 ± 15.71, respectively). In addition, mean post-test body mass index (27.19 ± 4.62 kg/m2 ), weight (74.81 ± 15.33 kg), waist circumference (93.29 ± 15.20 cm), hip circumference (107.67 ± 14.05 cm) and total cholesterol (178.43 ± 25.59 mg/dL) values were lower than pretest (28.13 ± 4.96 kg/m2 ; 77.37 ± 16.56 kg; 97.83 ± 16.23 cm; 112.89 ± 14.37 cm; 194.78 ± 38.64 mg/dL, respectively) in the intervention group. The nurse-led hypertension management program implemented in this study provides an example of an effective program to guide nurses who work with older adults. Geriatr Gerontol Int 2020; 20: 1182-1189.