Personalized Informational Support Improves Treatment Adherence in Hypertension: A Pre-Post Study (Preprint)

BACKGROUND Informational support has been demonstrated to enhance patients' treatment adherence. However, which specific mode of informational support is more effective for hypertension patients remains undetermined. OBJECTIVE The primary objective of this study was to examine the feasibility and effectiveness of an intervention combining in-person follow-ups and telephone counseling among patients with hypertension in a Chinese community setting. METHODS A pre-post design was employed to investigate the feasibility of providing informational support intervention to hypertension patients attending a community health facility in Chengdu, China. The intervention combined in-person follow-ups and telephone counseling. Adherence, clinical outcomes (blood pressure, ambulatory blood pressure, and laboratory tests) were measured at baseline and post-intervention. Patients' health behaviors were assessed at baseline and post-intervention using validated structured questionnaires. Descriptive statistics and effect sizes were calculated to determine clinically important changes relative to baseline. RESULTS Significant improvements were observed: medication adherence scores increased by 0.65 points (95% CI: 0.38 to 0.91; P<0.001); Nutrition scores increased by 1.31 points (95% CI: 0.53 to 2.09; P<0.001), interpersonal relations scores increased by 1.17 points (95% CI: 1.03 to 2.02; P=0.007), health responsibility scores increased by 2.42 points (95% CI: 0.33 to 3.80; P=0.001), and the total HPLP-IIR score significantly increased by 6.81 points (95% CI: 3.01 to 10.61; P=0.001) . Night-time systolic blood pressure decreased significantly by 5.07 mmHg (95% CI: -8.12 to -2.01; P=0.001), and night-time diastolic blood pressure decreased significantly by 3.39 mmHg (95% CI: -5.12 to -1.67; P<0.001). CONCLUSIONS This study provides preliminary data for a large-scale, adequately powered randomized controlled trial. The findings indicate that providing informational support to community-dwelling patients with hypertension can improve their adherence, enhance health behaviors, and improve blood pressure control. CLINICALTRIAL This study was registered with the Chinese Clinical Trial Registry under the identifier ChiCTR200003962.