Hypertensive Patients In Rural Areas Research Articles

Analysis of the Effect of Family-Centered Empowerment Model (FCEM) Health Education Through WeChat on Medication Compliance and Blood Pressure of Elderly Hypertensive Patients in Rural Areas

Objective: To validate the effectiveness of a Family-Centered Empowerment Model (FCEM) health education through WeChat on medication compliance and blood pressure among elderly hypertensive patients in rural areas. Methods: One hundred and two rural elderly hypertensive patients aged 65–80 years were selected and randomly divided into an experimental and control group of 51 each. The control group implemented conventional health education, and the experimental group implemented FCEM health education through WeChat platform for 4 consecutive weeks. The Therapeutic Adherence Scale for Hypertensive Patients (TASHP) scores and blood pressure measurements were compared between and within the two groups. Results: After the intervention, there were significant differences in medication compliance and blood pressure between the two groups (P < 0.001). In the control group, before and after the intervention, there was a significant difference in medication compliance (P < 0.001), but no significant difference in blood pressure (P > 0.05). In the experimental group, there were significant differences in medication compliance and blood pressure before and after the intervention (P < 0.001). Conclusion: The FCEM health education through an online social platform significantly improved medication compliance and led to effective blood pressure control in rural elderly hypertensive patients. Therefore, as an effective, safe, and economical model, it is also necessary to explore its effectiveness in improving health problems in other chronic diseases and other age groups.

Adherence and clinical outcomes of hypertensive patients in rural areas after receiving home pharmacy care interventions

Adherence is still a significant problem in the treatment of hypertension, so appropriate interventions are needed to overcome this condition. This study aims to determine the effect of home pharmacy care on medication adherence and clinical outcomes. This research is a pilot study using a quasi-experimental pre- and post-design with control in primary health care facilities in rural areas involving 40 hypertensive patients divided into two each 20 patients in the control and treatment groups. The MGLS questionnaire measured treatment adherence and clinical outcome by assessing blood pressure. Data were analyzed using descriptive statistics, bivariate tests using chi-square, Mann Whitney, paired t-test, and Wilcoxon signed ranks-test. At the beginning and end of the study there was no difference in the level of treatment adherence in the control group (p=0.701) while in the intervention group there was a significant difference (p=0.009). Systolic blood pressure in the control group (p=0.000) and the intervention group (p=0.004) showed a difference, while there was no difference in diastolic blood pressure in the two groups. In addition, there was no difference in achieving blood pressure targets between groups (p=0.522). The findings in this study are that home pharmacy services have the potential to increase medication adherence in rural areas but have not had an impact on reducing pressure and achieving targets.

家庭医生签约服务模式在农村老年高血压患者中的研究进展

家庭医生签约服务模式在农村老年高血压患者中的研究进展

Urban-Rural Difference in Treatment Adherence of Chinese Hypertensive Patients.

ObjectiveThe aims of this study were to evaluate the treatment adherence and the main factors associated with adherence for Chinese hypertensive patients between urban and rural areas.Participants and MethodsA total of 529 hypertensive patients with 328 from urban areas and 201 from rural areas hospitalized in a tertiary hospital in Xi’an, China during the period from May 1 to December 31, 2021 were invited to participate in the cross-sectional study. The adherence to treatment was assessed by “modified Chinese Hill-Bone compliance to high blood pressure therapy scale”. Binary logistic regression analysis was used to analyze independent risk factor for treatment adherence of hypertensive patients. General linear model was used to analyze the association of the independent risk factors to treatment adherence in each subgroup of the scale.ResultsThe treatment adherence of Chinese hypertensive patients in rural areas was 23.88% and it was significantly lower than that in urban areas (36.59%). Age and gender were the factors that independently associated with treatment adherence of hypertensive patients regardless of urban or rural status. The duration of antihypertensive drugs used was identified to be the factor that independently associated with treatment adherence only in urban patients. The subgroups including reduced sodium intake and medication taking had significant effects on treatment adherence in certain factors.ConclusionThe treatment adherence of Chinese hypertensive patients was low, especially in rural areas. More emphasis should be placed on patients in rural areas. Furthermore, more attention and effective strategies should be designed to address factors affecting treatment adherence in both urban and rural areas. Health programs should focus on education including the importance of taking continuous antihypertensive drugs and low sodium diet.

Salt Consumption and Blood Pressure in Rural Hypertensive Participants: A Community Filed Trial.

Purpose Hypertension is a major cause of morbidity and mortality in the world. This study aimed to evaluate an intervention based on the Health Belief Model regarding the whole family's salt consumption and blood pressure among hypertensive patients in rural areas in Iran. Methods This clinical multicenter trial (clinical and community) with a control and an intervention group was conducted on the residents of 14 villages covered by 14 health houses. Totally, 200 hypertensive patients (n = 100 in each group) were selected via multistage random sampling. The intervention included a two-day workshop on blood pressure and reducing salt consumption based on HBM structures for health personnel and an eight-session workshop on how to reduce salt intake and blood pressure for mothers who were responsible for the families' diets. Participants completed the questionnaires before and immediately after the intervention. Results Compared to the control group, in the intervention group, a significant reduction was observed in salt consumption by the families (urine sodium and creatinine reduced by 35 mEq/l and 7.5 mg/dL, respectively). The results also revealed a significant decrease in blood pressure in the intervention group. Conclusion The results showed that the mothers' model-based education could effectively improve the diet of the whole family members and, as a result, reduce the associated diseases. The main advantage of this study was the involvement of the rural health personnel, which helped run longer and larger-scale health-promotion programs in the communities.

Medication Adherence and Characteristics of Hypertensive Patients: A Study in Rural Areas

Hypertension is a risk factor for cardiovascular disease. Several studies have shown that control of hypertension is still low, and the main reason is the low medication adherence to taking medication for patients, especially in rural areas. It can lead to treatment failure, consequently increasing morbidity and mortality. The purpose of this study is to describe the adherence to medication and observance the characteristics of hypertensive patients in rural areas. A cross-sectional design is used in this study. It was adopted to facilitate the survey of hypertensive patients in rural areas. This research was conducted in several districts in the city of Pekanbaru which is a rural area. The sample consisted of 220 patients with hypertension using the quota sampling technique. The characteristics of patients were measured using a validated questionnaire, and patient adherence was measured by the MGL (Morisky, Green and Levine) adherence scale. The results of the study involving 220 respondents showed that the majority of respondents were women, with an age range of 45-59 years (middle age) and with a low level of education (elementary school graduates). The duration of illnesses was >1-5 years with the majority (50.9%) of patients having a low level of medication adherence. There is no association between patient’s characteristics and adherence. Adherence to taking medication for hypertensive patients in rural areas is low. Pharmacists need to give full attention and think of appropriate interventions to increase patient adherence with medication in rural areas.

Cross-sectional study of cardiovascular disease awareness and therapy management among hypertensive patients in rural areas in the Nellore district of Andhra Pradesh State

Recent Indian study protocol designed for the supervision of cardiovascular disease instructed as well as better therapeutic achievement underneath the accustomed cardiovascular disease inhabitants. After all, a few people (25%) of heart-related problems inhabitants being conscious, 80% of the people were treated; besides just 20% were composed. This study was conducted as a cross-sectional study laminated arbitrary examine and inspected during the period of 4th Mar 2017 to 3rd July 2017 in the form of order. The model framework was put up pedestal scheduled, the portal system of the area inhabitants record as of inhabitants in the sequence of Nellore. Analytical clue, hypertension situation, and way of life behavior of the contributors were revealed. Hereby observed hypertension occurrence, consciousness, therapy, management, and drugs. The study appearance 57.2% of observed inhabitants to exist confidential the same as blood pressure living being conscious of their earlier analysis of blood pressure. This deliberation has been observed as a laminated casual inspect characterizing the Indian developed inhabitants in city areas of Nellore, India. As well as-discussed training procedure was attended with employing a definitive covenant and tool and makes certain the superiority of the fact compilation agenda. This hypertension wellbeing control can be taught the communal base and it prevents the public from cardiovascular disease avoidance plan may be effectual and humanizing to manage the blood pressure.

The Effects of Social Support and Health Literacy on Depression among Rural Patients with Hypertension

To explore the effects of social support and health literacy on depression among hypertensive patients in rural areas and to provide reference for improving depression in hypertensive patients. A multi-stage stratified sampling method was used to select 549 hypertensive patients in a rural area of Chengdu city for a questionnaire survey. Structural equation model was used to analyze the effects of social support and health literacy on depression in hypertensive patients. Social support ( β=-0.116, 95% CI: (-0.198)-(-0.132)) and health literacy ( β=-0.209, 95% CI: (-0.289)-(-0.132)) had a direct negative effect on depression, and social support had a direct positive effect on health literacy ( β=0.146, 95% CI: 0.064-0.229). Health literacy was a mediator between social support and depression ( β=-0.030, 95% CI: (-0.054)-(-0.013)). The gender, employment status and per capita annual income of the patients affected the incidence of depression ( P<0.05). Social support and health literacy are important predictors of depression among hypertensive patients. We should construct a good social support network, strengthen the publicity of health knowledge, and improve social support and health literacy to alleviate the depression in hypertensive patients. At the same time, more attention should be paid to women, people with low per capita annual income and working hypertensive patients.

Knowledge, Attitudes and Practices towards Hypertension among Hypertensive Patients in Rural Area, Tanvè (Benin)

Hypertension mortality could be reduced by compliance with treatments and hygienic rules. The study aimed to assess the knowledge, attitudes and practices (KAPs) towards hypertension among hypertensive patients at Tanve (Benin) in 2018. Materials and Methods: This was a cross-sectional study. It included, people aged 25 and over, followed in Tanve Health Study and screened hypertensive during the 2017 visit. An individual interview was used for the data collection in 2018. The evaluation of the KAPs was made by questions with two optional answers, marked 0 or 1: 24 for knowledge, 8 for attitudes and 12 for practices. The level was rated good when the score was ≥ 3rd quartile of the theoretical score. Results: A total of 380 people were surveyed, 67.9% of whom were women; the mean age was 52.4 ± 16.5 years. Among them, 22.6% had a good level of knowledge and 89.7% had good attitudes. Only 50.1% of the respondents were aware of their history of hypertension. Few of them (5.2%) had good practices towards hypertension. Conclusion: This study shows a low level of knowledge and practices towards hypertension. Interventions for the therapeutic education of hypertensive patients would be effective within the target population.

Health-related quality of life among rural men and women with hypertension: assessment by the EQ-5D-5L in Jiangsu, China.

Hypertension is a major global public health problem, including rural China. However, studies examining health-related quality of life (HRQoL) for patients with hypertension have been mostly conducted in urban populations. This study aimed to use the EuroQol five-dimensional-five-level (EQ-5D-5L) and its recently developed Chinese value set to analyze HRQoL and its influencing factors among hypertensive population in rural China. This is a cross-sectional population-based survey. Standard interview of participants was conducted from July to September 2016 in Donghai County's 334 villages of Jiangsu Province, China. Data collection included the EQ-5D-5L, along with sociodemographic characteristics and disease-related factors such as duration of hypertension, antihypertensive treatment and comorbid conditions. The Tobit regression model was employed to analyze potential influencing factors on HRQoL. A total of 16,596 adults (18years and older) with hypertension participated in this study. 62.4% were women. The mean utility score was 0.85 (standard deviation [SD] = 0.23). The proportion of participants reporting pain/discomfort problems was highest, while least patients reported problems in self-care dimension. Females, elderly, illiterate patients, ex-smokers and patients with longer duration of hypertension or comorbidities scored lower on HRQoL than others. Stroke, heart failure and coronary heart disease were associated with a larger negative impact on HRQoL among all comorbidities. The HRQoL was lower in this rural hypertensive population than previously reported urban counterparts. To improve the HRQoL of hypertensive patients in rural areas, it is important to control hypertension and prevent its associated co-morbidities. More attention needs to be directed to elderly female patients with less education who scored much lower HRQoL than their male counterparts.

Lay perspectives on causes and complications of hypertension; and barrier to access health care by known hypertensive patients: a qualitative study from a rural area of South India

Background: Global prevalence of hypertension in the year 2000 was estimated to be 26% with approximately 1 billion people affected by it. By 2025 this has been projected to increase to 29% increase to 29%, expecting greater proportion of population will be consists of elderly people. Limited qualitative studies on hypertension are available in India. We intended to conduct a qualitative study on the perception about hypertension causes, complications and barrier to get medications, among known hypertensive patients residing in rural area or south India.Methods: A qualitative study has been undertaken in August 2016 by the interns posted in Rural Health Training Centre of Pondicherry Institute of Medical Sciences (RHTC-PIMS). The study was completed after conducting in depth interview among 40 randomly selected known hypertensive patients. All the interviews were audio taped. Verbatim were done from the recording in local language (Tamil) and then translated to English. Coding and thematic analysis was done by analysis team consisting of one Assistant Professor in Community Medicine, one medical social worker (MSW) and three interns.Results: There is a huge lack of awareness about the causes of hypertension among the patients. There is also a huge lack of awareness about the complications of hypertension, among hypertensive patients. This may result in poor adherence to medication and prevention of complications. Almost all the patients reported that they were following Allopathic medications and getting medications from government primary health centre. There is a need to visit the health centre every week, as the medicines provided to them are only weekly basis.Conclusions: There is a huge lack of knowledge about hypertension among known hypertensive patients. There is a need for a holistic approach in managing hypertensive patients in rural area in India.

A community-based study to assess the treatment adherence and its determinants among hypertensive patients residing in a rural area of Kancheepuram district, Tamil Nadu

Background: Hypertension exerts a massive public health burden on cardiovascular health and health system in India. Objectives: The aim of this study is to assess the level of treatment adherence among the known hypertensive patients in a rural community and identify the determinants for non-adherence to treatment among them. Materials and Methods: A community-based cross-sectional descriptive study was conducted for 2 months in Sembakkam and Kottamedu villages under the rural field practice area of a medical college among known cases of hypertension diagnosed and initiated on antihypertensive therapy at least 3 months back. A total of 170 hypertensive patients were included as study participants using random sampling, and the desired information was obtained using a semi-structured schedule, and details about treatment adherence based on the Morisky Medication Adherence Scale. Ethical clearance was obtained from the Institutional Ethics Committee before the start of the study. Written informed consent was obtained from the study participants before eliciting any information from them. Statistical analysis was done using SPSS version 18. Frequency distributions were calculated for all the variables. Chi-square test was used for testing the significance of association at P = 0.05. Results: Among the study participants, 81 (47.6%) had good medication adherence, whereas 89 (52.4%) had poor adherence. A statistically significant association was observed between indulging in regular physical activity and use of salt-restricted diet and a good level of treatment adherence. Poor adherence to treatment was found more commonly among patients who were prescribed multiple antihypertensive drugs and those with more than once daily dose formulation. Conclusion: The study indicates that prevalence of treatment adherence among hypertensive patients in rural areas of Tamil Nadu was only 47.6% and there is a lot of scope for improvement. The study has also identified the crucial factors responsible for non-compliance to antihypertensive treatment which can assist the health-care policy makers to formulate a comprehensive strategy to achieve adequate compliance.

Assessment knowledge and life-style practices of patients with hypertension among their disease in rural area of Kirkuk city

Background: hypertension also known as increase of blood pressure is consider a main factor for heart and vascular disease around world . More than 60 % around world suffering from hypertension and lead to dead more than nine million patients per year. Aim of the study:- In order to assess patients knowledge and life-style practices for hypertensive patients in rural area of Kirkuk city , find out the relationship between patients knowledge and some socio-demographic characteristic ( age and gender ). Methodology A descriptive study of a quantitative design was conducted at Alhwija General Hospital in Alhawija district for hypertension patients in Kirkuk city from 3rd July 2013 to the 20th of March 2014. A non-probability (purposive) sample of (200) definitely diagnosed hypertension patients selected from adult patients who were attended to Alhwija General Hospital . For the purpose of data collection, a questionnaire format was constructed which contains (57 ) Demographic data include ( 6 ) items , medical data include (6) items knowledge of the Patients include (36) items and life-style practices for hypertensive patients include (9) items. Statistical analysis was used of 3- likert scale option was used in the rating scale as: (3) for yes , (2 ) for uncertain ,and ( 1 ) for no. Content validity was determined by presenting the questionnaire to a panel of (10) experts. The data were collected through the interviewing . They were analyzed through the application of descriptive statistical analysis (frequency and percentage) and inferential statistical data analysis (chi-square) , T. test and ANOVAs . Results :-The findings of the study indicated that No (62%) of the patients were in age group between (45_64)years , No(74%) were females, No(73%) married ,(73% ) were house wife, (55%) illiterate, (53%) had middle monthly income, also the study show most of the sample were not cigarette smokers that represent (86%),and family history for Hypertension and represent (57.5% ) Conclusions:- The study concluded 70% of the patients have inadequate knowledge related to disease, and 65% of them have inadequate practice regarding to the hypertension control . Also the study concluded that there is a highly significant relationship between hypertension patient’s age and their knowledge. Recommendation :-Based on the results , the study recommended Educational programs should be designed to increase people knowledge , awareness about their life style .Booklet should be prepared and presented to the patients to advise them to leave high amount salt intake, encourage patients about exercise which is considered one of the contributing factors for hypertension and construct a specialized modern centers for dealing hypertensive patients

Psychometric testing of an instrument designed to measure nutritional perceptions of hypertensive patients.

Introduction:Measurement tools designed to ensure the achievements of studies’ objectives must be evaluated. Based on the health promotion model (HPM), the present study was conducted to assess the validity and reliability of the designed questionnaire of hypertensive patients’ nutritional perceptions.Methodology:In a cross-sectional study, the mentioned questionnaire was assessed based on opinions of 11 experienced faculty members and 671 hypertensive patients in rural areas in the year 2013. To evaluate the reliability, internal consistency (Cronbach's alpha) was calculated. Concerning the validity of the questionnaire, its content and construct validity were examined. Data analysis was performed using Statistical Package for the Social Sciences version 18 (SPSS Inc., Chicago, IL, USA).Results:Spearman-Brown and Cronbach's alpha coefficients results were acceptable in all constructs indicating a satisfactory reliability of the questionnaire. Questionnaire's questions were highly correlated with the total score signifying the internal consistency of the questions; therefore, all questions had a similar effect on the total score and the removal of each did no increase the alpha significantly (all questions had acceptable reliability). Factor analyses showed that all questions had acceptable factor loading and suitable validity. Moreover, the entire constructs of the questionnaire were approved by experts with high validity coefficient of 0.9.Conclusion:The designed questionnaire for assessment of the HPM constructs regarding hypertensive patients’ nutritional issues had appropriate psychometric characteristics. Reliability and validity of the questionnaire were also satisfactory and its overall structure was approved.

GW24-e3900 The association between glomerular filtration rate and stroke in hypertensive patients in rural areas of China

ObjectivesThe present study is to explore the association between estimated glomerular filtration rate (eGFR) and stroke in hypertensive patients in rural areas of China.MethodsThe prospective study was based on 3711...

The association between glomerular filtration rate and stroke in hypertensive patients in rural areas of China

The present study is to explore the association between estimated glomerular filtration rate (eGFR) and stroke in hypertensive patients in rural areas of China. The prospective study was based on 3711 hypertensive patients who were aged at least 35 years, free from cardiovascular diseases, and had serum creatinine at baseline. eGFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation. During a median follow-up of 4.9 years, 176 first-ever strokes (98 ischemic, 75 hemorrhagic, and three were unspecified strokes) occurred. We found no independent association between eGFR and risk of hemorrhagic stroke. In contrast, with decreasing eGFR, the risk of total and ischemic stroke strongly increased; the sex and age-adjusted hazard ratios for overall and ischemic stroke were 3.34 [95% confidence interval (CI) 1.61-6.93] and 3.79 (95% CI 1.33-10.81) for patients with eGFR below 60 versus eGFR at least 90 ml/min per 1.73 m, respectively. In addition, patients with an eGFR of 60-90 relative to eGFR at least 90 ml/min per 1.73 m had hazard ratios of 2.31 (95% CI 1.53-3.51) and 3.24 (95% CI 1.76-6.00) for overall and ischemic stroke after adjustment for sex and age, respectively. Adjustment for other cardiovascular factors only slightly attenuated the associations. The patients with decreased eGFR, also included those with eGFR range between 60 and 90 ml/min per 1.73 m, had an independently increased risk of overall and ischemic stroke in hypertensive patients in rural areas of China.

Decreased Glomerular Filtration Rate Is Associated with Mortality and Cardiovascular Events in Patients with Hypertension: A Prospective Study

BackgroundFew studies reported the associations between decreased glomerular filtration rate (GFR) and mortality, coronary heart disease (CHD), and stroke in hypertensive patients. We aim to assess the associations between GFR and mortality, CHD, and stroke in hypertensive patients and to evaluate whether low GFR can improve the prediction of these outcomes in addition to conventional cardiovascular risk factors.Methods and FindingsThis is an observational prospective study and 3,711 eligible hypertensive patients aged ≥5 years from rural areas of China were used for the present analysis. The associations between eGFR and outcomes, followed by a median of 4.9 years, were evaluated using Cox proportional hazards models adjusting for other potential confounders. Low eGFR was independently associated with risk of all-cause mortality, cardiovascular mortality, and incident stroke [multivariable adjusted hazard ratios (95% confidence intervals) for eGFR <60 ml/min/1.73 m2 relative to eGFR ≥90 ml/min/1.73 m2 were 1.824 (1.047–3.365), 2.371 (1.109–5.068), and 2.493 (1.193–5.212), respectively]. We found no independent association between eGFR and the risk of CHD. For 4-year all-cause and cardiovascular mortality, integrated discrimination improvement (IDI) was positive when eGFR were added to traditional risk factors (1.51%, P = 0.016, and 1.99%, P = 0.017, respectively). For stroke and CHD events, net reclassification improvements (NRI) were 5.9% (P = 0.012) and 1.8% (P = 0.083) for eGFR, respectively.ConclusionsWe have established an inversely independent association between eGFR and all-cause mortality, cardiovascular mortality, and stroke in hypertensive patients in rural areas of China. Further, addition of eGFR significantly improved the prediction of 4-year mortality and stroke over and above that of conventional risk factors. We recommend that eGFR be incorporated into prognostic assessment for patients with hypertension in rural areas of China.LimitationsWe did not have sufficient information on atrial fibrillation to control for the potential covariate. These associations should be further confirmed in future.