Key result
Group education increases full HBPM knowledge odds ~8.5-fold compared to individual counseling.
Why the study?
Little is known whether patients with lower health literacy can retain the practice and knowledge of home blood pressure monitoring after an educational programme.
Does HBPM group education improve practice and knowledge of HBPM in patients with uncontrolled hypertension compared to individual counselling?
RCT (n=287)
Cluster
Yes
Does HBPM group education improve practice and knowledge of HBPM in patients with uncontrolled hypertension compared to individual counselling?
Effect estimate: aOR 8.46 (95% CI 4.68-15.28)
p-value: p=<0.001
Group education for home blood pressure monitoring significantly improves knowledge retention and body weight reduction compared to individual counseling in patients with uncontrolled hypertension.
Group education should be prioritized for HBPM training in uncontrolled hypertension; extends individual counseling with RCT evidence on knowledge retention.
BACKGROUND: Little is known whether patients with lower health literacy could retain the practice and knowledge of home blood pressure monitoring (HBPM) after an educational programme. METHODS: A cluster randomised controlled trial in five primary care clinics recruited participants with uncontrolled hypertension. Clinics were randomised either to a HBPM group education (Risk Assessment and Management Programme (RAMP-group), or individual counselling of self-management (RAMP-individual). Health literacy was assessed by the Chinese Health Literacy Scale for Chronic Care. Practice and knowledge of HBPM were surveyed by a 10-item HBPM knowledge checklist and patient record review 6 months after interventions. Predictors for regular HBPM and good HBPM knowledge were assessed by multivariate logistic regression models. RESULTS: 287 participants (RAMP-group: 151; RAMP-individual: 136) were follow-up for 6 months. 272 participants completed the knowledge questionnaires (response rate 94.8%). 67.8% of the participants performed HBPM regularly, and there was no statistical difference between both interventions. Age more than 65 (adjusted odds ratios (aOR) 2.58, 95% CI 1.37 to 4.86, p=0.003), not working (aOR 2.34, 95% CI 1.10 to 4.97, p=0.027)and adequate health literacy (aOR 2.25, 95% CI 1.28 to 3.95, p=0.005) predicted regular HBPM. Participants in RAMP-group demonstrated a significant lower body weight than those in RAMP-individual (-0.3±2.0 kg vs +0.7 ±1.7 kg, p<0.001).The RAMP-group participants were eight times more likely to have full HBPM knowledge score than the RAMP-individual participants (aOR 8.46, 95% CI 4.68 to 15.28, p<0.001). CONCLUSION: Patients could retain HBPM knowledge better after RAMP-group than RAMP-individual. Older, retired and patients with adequate health literacy were more likely to continue weekly HBPM 6 months after education. TRIAL REGISTRATION NUMBER: NCT02551393.
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Fu et al. (2021) conducted an RCT in uncontrolled hypertension (n=287). HBPM group education (RAMP-group) vs. individual counselling of self-management (RAMP-individual) was evaluated on full HBPM knowledge score (aOR 8.46, 95% CI 4.68-15.28, p=<0.001). Group education (RAMP-group) significantly increased the likelihood of achieving a full HBPM knowledge score at 6 months compared to individual counseling (aOR 8.46; 95% CI 4.68-15.28; p<0.001).
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