Abstract
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.
Highlights
The burden of hypertension and diabetes has been on the increase because of the increasing adult population and changes in lifestyles of Nigerians [1]
Recent studies have shown that patients who take their medications without engaging in dietary changes or physical activity have no higher rate of improved blood pressure than those who engaged in dietary changes and physical activities without taking their medications as at when due [6]
The eligibility criteria were: Ambulatory patient; patients who had hypertension with only diabetes mellitus type II co-morbidity; patients who were aged ≥ 1 8 y and ≤ 7 0 y; patients who must have received at least one anti-hypertensive drug during the 30 d period preceding the beginning of the recruitment; patients who have no history of significant cardiac complications in the past 6 mo; patients who history of compliance with regular clinic visits within the last 2 y; those who are not pregnant prior to recruitment; patients who are able to communicate freely in English language and patients who gave their consent to participate
Summary
The burden of hypertension and diabetes has been on the increase because of the increasing adult population and changes in lifestyles of Nigerians [1]. Studies have identified patient’s lack of knowledge related to self-management in terms of adherence to medications, and modification of lifestyle behaviours, as major factors that contribute to the poor control of blood pressure [2]. Studies have demonstrated the effects of self-care behaviours in the proper management of hypertension [4]. Medication adherence alone has proven not to be sufficient in the optimal management of blood pressure [5]. Studies have proved that adherence to hypertension self-care activities could lead to optimal control of blood pressure, increased efficacy of antihypertensive medications, reduced complications, morbidity and mortality [7]. The objective of this study was to evaluate the effect of a pharmacistled intervention on self-management practices among hypertensivediabetic patients receiving care in a Nigeria tertiary hospital
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
