TITLE:
How Group-Based Cardiovascular Health Education Affects Treatment Adherence and Blood Pressure Control among Insured Hypertensive Nigerians: A Pre-Test, Post-Test Study
AUTHORS:
Aina Olufemi Odusola, Heleen Nelissen, Marleen Hendriks, Constance Schultsz, Ferdinand Wit, Oladimeji Akeem Bolarinwa, Tanimola Akande, Charles Agyemang, Gbenga Ogedegbe, Kayode Agbede, Peju Adenusi, Akin Osibogun, Karien Stronks, Joke Haafkens
KEYWORDS:
BP-Control, Education, Adherence, Self-Efficacy, Insurance, Nigeria
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.5 No.7,
July
30,
2015
ABSTRACT: In sub Saharan Africa (SSA), access to affordable hypertension care through health insurance is increasing. But due to poor adherence, hypertension treatment outcomes often remain poor. Patient-centered educational interventions may reverse this trend. Using a pre-test/post-test design, in this study we investigated the effects of a structured cardiovascular health education program (CHEP) on treatment adherence, blood pressure (BP) control and body mass index (BMI) among Nigerian hypertensive patients who received guideline-based care in a rural primary care facility, in the context of a community based health insurance program. Study participants included 149 insured patients with uncontrolled BP and/or poor self-reported medication adherence after 12 months of guideline-based care. All patients received three group-based educational sessions and usual primary care over 6 months. We evaluated changes in self-reported adherence to prescribed medications and behavioral advice (primary outcomes); systolic BP (SBP) and/or diastolic BP (DBP) and BMI (secondary outcomes); and beliefs about hypertension and medications (explora- tory outcomes). Outcomes were analyzed with descriptive statistics and regression analysis. 140 patients completed the study (94%). At 6 months, more participants reported high adherence to medications and behavioral advice than at baseline: respectively, 101 (72%) versus 70 (50%), (p