Key result
Home-based self-care education improves medication adherence vs routine care but fails to lower BP.
Why the study?
Self-care education through home visits has potential effects on self-care, but its effects on blood pressure and self-care behaviors required evaluation in middle-aged patients with primary hypertension in Iran.
Does a 2-month home-based self-care education program improve blood pressure and self-care behaviors in middle-aged patients with primary hypertension?
RCT (n=110)
Simple randomization
Yes
Does a 2-month home-based self-care education program improve blood pressure and self-care behaviors in middle-aged patients with primary hypertension?
Absolute Event Rate: 17.42% vs 14.49%
p-value: p=.04
Home-based self-care education improves self-care behaviors in middle-aged patients with primary hypertension, though its effect on blood pressure reduction requires further study.
Home-based self-care education may boost adherence without short-term BP reduction; extends behavioral RCT evidence but leaves BP efficacy open.
Self-care education (SCE) through home visit is one of the methods with potential effects on self-care. This study aimed to evaluate the effects of home-based SCE on blood pressure and self-care behaviors among middle-aged patients with primary hypertension in Iran. This randomized controlled trial was conducted on 110 middle-aged patients with hypertension recruited from public healthcare centers in the south of Tehran, Iran in September 2019. After convenience sampling, Participants were simple randomly allocated to control and intervention groups. Intervention group received a 2-month home-based SCE while control group received routine care services. Before and 2 months after the intervention, self-care behaviors were assessed using the Hypertension Self-Care Activity Level Effects (H-SCALE). Data were analyzed using the SPSS software (v. 16.0) at a significance level of less than .05. After 2 months, the posttest mean scores of self-care behaviors in medication adherence (17.42 ± 1.03 vs 14.49 ± 1.01, p = .04), physical activity (8.16 ± 0.39 vs 6.47 ± 0.52, p = .01), low-salt diet (52.51 ± 3.8 vs 35.36 ± 3.47, p = .001), and blood pressure control (3.47 ± 0.22 vs 2.42 ± 1.89, p = .001), in the intervention group were significantly greater than the control group. However, there were no significant between-group differences respecting the posttest mean scores of the weight management ( p = .06) and smoking cessation ( p = .2). Also, the mean blood pressure between the 2 groups changed after the intervention, but this difference was not statistically significant. This study suggests the effectiveness of home-based SCE in significantly improving self-care behaviors among patients with hypertension. But more studies are needed to measure the effectiveness of intervention on blood pressure. IRCT code: IRCT20190623043985N1. Registered 06/30/2019, https://fa.irct.ir/trial/40351 .
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Gonbad et al. (2021) conducted an RCT in Primary hypertension (n=110). Home-based self-care education vs. Routine care services was evaluated on Self-care behaviors in medication adherence score (p=.04). Home-based self-care education significantly improved medication adherence scores compared to routine care (17.42 vs 14.49; p=0.04), but did not significantly reduce mean blood pressure.
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