Hypertension management: what is the role of case management?

Nurhan Ozpancar,Birol Topcu,Sezgi Cinar Pakyuz

doi:10.1590/s1980-220x2017016903291

Nurhan Ozpancar, Birol Topcu + Show 1 more

Open Access

https://doi.org/10.1590/s1980-220x2017016903291

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Abstract

Objective The aim of this study was to determine the effect of case management on hypertension management and on adherence to antihypertensive medication and chronic disease care of patients with hypertension. Method This study was conducted as an experimental and randomized controlled study. The sample of the study consisted of randomly selected patients with hypertension who did not have communication problems, who used antihypertensive medication treatment and whose treatment had been continuing for at least six months. The study group was given individual training (Hypertension causes, the risk factors, significance, unwanted side effects, medication treatment, changes in life style) and was applied case management model in hypertension - joint care protocol but no intervention was offered to the control group. Data was collected using the adherence to antihypertensive medication scale, the patient assessment of chronic illness care in the first and six months later interview. Results There was no significant difference between the study and control group according to adherence to antihypertensive medication and patient assessment of chronic illness care in the first interview. Otherwise, there were significant differences between the study and control group according to blood pressure, adherence to antihypertensive medication and patient assessment of chronic illness care in the six months later interview. The adherence to antihypertensive medication total score and the patient assessment of chronic illness care total score were significantly higher in the study group compared with control group in the six months later interview. Conclusion The case management plays an important role the in control of hypertension, and can improve adherence to antihypertensive medication and chronic illness care.

Highlights

Hypertension is one of the leading global risk factors for disease load and mortality
The study population for this randomized, controlled and experimental study consisted of individuals diagnosed with hypertension whose treatment/follow-up continued between February 2012 and January 2013 at the General Internal Medicine and Cardiology Outpatient Clinics, and who were prescribed with antihypertensive medication treatment
It was observed in both groups that the majority of the patients did not diet with respect to hypertension and that they noticed their increasing blood pressure

Summary

Introduction

Hypertension is one of the leading global risk factors for disease load and mortality. Hypertension causes death in 6% of the total population, in other words approximately 7.6 million individuals. If untreated, it can shorten life, and become a major risk factor for coronary, cerebral, renal and vascular diseases[1]. Keeping hypertension under control using pharmacological or non-pharmacological approaches requires individuals to adhere to their treatment, and to make various lifestyle changes. As well as in Turkey, one of the most important factors preventing blood pressure control beyond 25% is patient non-adherence to treatment[2]. Nonadherence may start with avoidance of medicinal treatment and not taking his/her prescriptions.Not attending the clinic regularly for control, as well as continuing unhealthy habits such as smoking, insufficient physical activity, excess calorie intake, a diet rich in fat and sodium, are the most common and important forms of non-adherence[3]

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Discussion

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