Cargando…

Culturally Adapted Hypertension Education (CAHE) to Improve Blood Pressure Control and Treatment Adherence in Patients of African Origin with Uncontrolled Hypertension: Cluster-Randomized Trial

OBJECTIVES: To evaluate the effect of a practice-based, culturally appropriate patient education intervention on blood pressure (BP) and treatment adherence among patients of African origin with uncontrolled hypertension. METHODS: Cluster randomised trial involving four Dutch primary care centres an...

Descripción completa

Detalles Bibliográficos
Autores principales: Beune, Erik J. A. J., Moll van Charante, Eric P., Beem, Leo, Mohrs, Jacob, Agyemang, Charles O., Ogedegbe, Gbenga, Haafkens, Joke A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3943841/
https://www.ncbi.nlm.nih.gov/pubmed/24598584
http://dx.doi.org/10.1371/journal.pone.0090103
_version_ 1782306308254334976
author Beune, Erik J. A. J.
Moll van Charante, Eric P.
Beem, Leo
Mohrs, Jacob
Agyemang, Charles O.
Ogedegbe, Gbenga
Haafkens, Joke A.
author_facet Beune, Erik J. A. J.
Moll van Charante, Eric P.
Beem, Leo
Mohrs, Jacob
Agyemang, Charles O.
Ogedegbe, Gbenga
Haafkens, Joke A.
author_sort Beune, Erik J. A. J.
collection PubMed
description OBJECTIVES: To evaluate the effect of a practice-based, culturally appropriate patient education intervention on blood pressure (BP) and treatment adherence among patients of African origin with uncontrolled hypertension. METHODS: Cluster randomised trial involving four Dutch primary care centres and 146 patients (intervention n = 75, control n = 71), who met the following inclusion criteria: self-identified Surinamese or Ghanaian; ≥20 years; treated for hypertension; SBP≥140 mmHg. All patients received usual hypertension care. The intervention-group was also offered three nurse-led, culturally appropriate hypertension education sessions. BP was assessed with Omron 705-IT and treatment adherence with lifestyle- and medication adherence scales. RESULTS: 139 patients (95%) completed the study (intervention n = 71, control n = 68). Baseline characteristics were largely similar for both groups. At six months, we observed a SBP reduction of ≥10 mmHg -primary outcome- in 48% of the intervention group and 43% of the control group. When adjusted for pre-specified covariates age, sex, hypertension duration, education, baseline measurement and clustering effect, the between-group difference was not significant (OR; 0.42; 95% CI: 0.11 to 1.54; P = 0.19). At six months, the mean SBP/DBD had dropped by 10/5.7 (SD 14.3/9.2)mmHg in the intervention group and by 6.3/1.7 (SD 13.4/8.6)mmHg in the control group. After adjustment, between-group differences in SBP and DBP reduction were −1.69 mmHg (95% CI: −6.01 to 2.62, P = 0.44) and −3.01 mmHg (−5.73 to −0.30, P = 0.03) in favour of the intervention group. Mean scores for adherence to lifestyle recommendations increased in the intervention group, but decreased in the control group. Mean medication adherence scores improved slightly in both groups. After adjustment, the between-group difference for adherence to lifestyle recommendations was 0.34 (0.12 to 0.55; P = 0.003). For medication adherence it was −0.09 (−0.65 to 0.46; P = 0.74). CONCLUSION: This intervention led to significant improvements in DBP and adherence to lifestyle recommendations, supporting the need for culturally appropriate hypertension care. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN35675524
format Online
Article
Text
id pubmed-3943841
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-39438412014-03-10 Culturally Adapted Hypertension Education (CAHE) to Improve Blood Pressure Control and Treatment Adherence in Patients of African Origin with Uncontrolled Hypertension: Cluster-Randomized Trial Beune, Erik J. A. J. Moll van Charante, Eric P. Beem, Leo Mohrs, Jacob Agyemang, Charles O. Ogedegbe, Gbenga Haafkens, Joke A. PLoS One Research Article OBJECTIVES: To evaluate the effect of a practice-based, culturally appropriate patient education intervention on blood pressure (BP) and treatment adherence among patients of African origin with uncontrolled hypertension. METHODS: Cluster randomised trial involving four Dutch primary care centres and 146 patients (intervention n = 75, control n = 71), who met the following inclusion criteria: self-identified Surinamese or Ghanaian; ≥20 years; treated for hypertension; SBP≥140 mmHg. All patients received usual hypertension care. The intervention-group was also offered three nurse-led, culturally appropriate hypertension education sessions. BP was assessed with Omron 705-IT and treatment adherence with lifestyle- and medication adherence scales. RESULTS: 139 patients (95%) completed the study (intervention n = 71, control n = 68). Baseline characteristics were largely similar for both groups. At six months, we observed a SBP reduction of ≥10 mmHg -primary outcome- in 48% of the intervention group and 43% of the control group. When adjusted for pre-specified covariates age, sex, hypertension duration, education, baseline measurement and clustering effect, the between-group difference was not significant (OR; 0.42; 95% CI: 0.11 to 1.54; P = 0.19). At six months, the mean SBP/DBD had dropped by 10/5.7 (SD 14.3/9.2)mmHg in the intervention group and by 6.3/1.7 (SD 13.4/8.6)mmHg in the control group. After adjustment, between-group differences in SBP and DBP reduction were −1.69 mmHg (95% CI: −6.01 to 2.62, P = 0.44) and −3.01 mmHg (−5.73 to −0.30, P = 0.03) in favour of the intervention group. Mean scores for adherence to lifestyle recommendations increased in the intervention group, but decreased in the control group. Mean medication adherence scores improved slightly in both groups. After adjustment, the between-group difference for adherence to lifestyle recommendations was 0.34 (0.12 to 0.55; P = 0.003). For medication adherence it was −0.09 (−0.65 to 0.46; P = 0.74). CONCLUSION: This intervention led to significant improvements in DBP and adherence to lifestyle recommendations, supporting the need for culturally appropriate hypertension care. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN35675524 Public Library of Science 2014-03-05 /pmc/articles/PMC3943841/ /pubmed/24598584 http://dx.doi.org/10.1371/journal.pone.0090103 Text en © 2014 Beune et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Beune, Erik J. A. J.
Moll van Charante, Eric P.
Beem, Leo
Mohrs, Jacob
Agyemang, Charles O.
Ogedegbe, Gbenga
Haafkens, Joke A.
Culturally Adapted Hypertension Education (CAHE) to Improve Blood Pressure Control and Treatment Adherence in Patients of African Origin with Uncontrolled Hypertension: Cluster-Randomized Trial
title Culturally Adapted Hypertension Education (CAHE) to Improve Blood Pressure Control and Treatment Adherence in Patients of African Origin with Uncontrolled Hypertension: Cluster-Randomized Trial
title_full Culturally Adapted Hypertension Education (CAHE) to Improve Blood Pressure Control and Treatment Adherence in Patients of African Origin with Uncontrolled Hypertension: Cluster-Randomized Trial
title_fullStr Culturally Adapted Hypertension Education (CAHE) to Improve Blood Pressure Control and Treatment Adherence in Patients of African Origin with Uncontrolled Hypertension: Cluster-Randomized Trial
title_full_unstemmed Culturally Adapted Hypertension Education (CAHE) to Improve Blood Pressure Control and Treatment Adherence in Patients of African Origin with Uncontrolled Hypertension: Cluster-Randomized Trial
title_short Culturally Adapted Hypertension Education (CAHE) to Improve Blood Pressure Control and Treatment Adherence in Patients of African Origin with Uncontrolled Hypertension: Cluster-Randomized Trial
title_sort culturally adapted hypertension education (cahe) to improve blood pressure control and treatment adherence in patients of african origin with uncontrolled hypertension: cluster-randomized trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3943841/
https://www.ncbi.nlm.nih.gov/pubmed/24598584
http://dx.doi.org/10.1371/journal.pone.0090103
work_keys_str_mv AT beuneerikjaj culturallyadaptedhypertensioneducationcahetoimprovebloodpressurecontrolandtreatmentadherenceinpatientsofafricanoriginwithuncontrolledhypertensionclusterrandomizedtrial
AT mollvancharanteericp culturallyadaptedhypertensioneducationcahetoimprovebloodpressurecontrolandtreatmentadherenceinpatientsofafricanoriginwithuncontrolledhypertensionclusterrandomizedtrial
AT beemleo culturallyadaptedhypertensioneducationcahetoimprovebloodpressurecontrolandtreatmentadherenceinpatientsofafricanoriginwithuncontrolledhypertensionclusterrandomizedtrial
AT mohrsjacob culturallyadaptedhypertensioneducationcahetoimprovebloodpressurecontrolandtreatmentadherenceinpatientsofafricanoriginwithuncontrolledhypertensionclusterrandomizedtrial
AT agyemangcharleso culturallyadaptedhypertensioneducationcahetoimprovebloodpressurecontrolandtreatmentadherenceinpatientsofafricanoriginwithuncontrolledhypertensionclusterrandomizedtrial
AT ogedegbegbenga culturallyadaptedhypertensioneducationcahetoimprovebloodpressurecontrolandtreatmentadherenceinpatientsofafricanoriginwithuncontrolledhypertensionclusterrandomizedtrial
AT haafkensjokea culturallyadaptedhypertensioneducationcahetoimprovebloodpressurecontrolandtreatmentadherenceinpatientsofafricanoriginwithuncontrolledhypertensionclusterrandomizedtrial