Impact of Cognitive and Behavioural Psychosocial Interventions on the Effective Management of Hypertension

Abstract

Hypertension or elevated blood pressure is a chronic non-communicable disease, in which the force of the circulating blood through the major blood vessels and arteries of the body, is consistently high leading to severe health complications. Given the high rates of unawareness of the condition and low rates of detection, diagnosis and treatment of high BP, which has been termed as the “silent killer”, patients tend to be non-adherent to their treatment regimen which lowers their blood pressure control, quality of life and prognosis. A community-based cluster randomized controlled trial, that utilized a 4x3 factorial between-subjects experimental design, was adopted to determine the simultaneous and comparative impact, of three cognitive and behavioural psychosocial interventions on the systolic and diastolic BP control, hypertension knowledge, therapeutic adherence, health beliefs and self-efficacy among hypertensive patients, across the three time points of the study. A sample of 224 hypertensive participants were randomly selected from the four villages of Railapur, Athvelly, Nuthankal, and Rawalkol and were randomly assigned to the Doctor, Video, Community Health Worker and Control conditions respectively. The results showed that the hypertensive patients in the three psychosocial intervention groups showed significantly higher therapeutic adherence, blood-pressure control, hypertension-related knowledge, hypertension-related health beliefs and self-efficacy as compared to the control group after the administration of the interventions. By means of pathway modelling using multiple linear regression analyses, the three psychosocial interventions were found to be direct, significant, and positive predictors of the therapeutic adherence among hypertensive patients, which in turn was the largest, significant and negative contributor to the systolic and diastolic BP reading among them.