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Use of family member-based supervision in the management of patients with hypertension in rural China

Authors Huang S, Chen Y, Zhou J, Wang J

Received 24 April 2014

Accepted for publication 5 June 2014

Published 31 July 2014 Volume 2014:8 Pages 1035—1042

DOI https://doi.org/10.2147/PPA.S66777

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 5

Susan Huang,1,2,* Ye Chen,2,* Jing Zhou,2 Jianming Wang1,2

1Department of Social Medicine and Health Education, 2Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, People’s Republic of China

*These authors contributed equally to this work

Abstract: Medication nonadherence is a major problem in the management of hypertension. The aim of this study was to develop a family member-based supportive therapy for patients with hypertension to provide an affordable way to access essential health services and to ensure adequate control of blood pressure. This study applied a mixed methods approach using qualitative and quantitative study designs in Yangzhong County, a rural area in the People’s Republic of China. Findings from indepth interviews demonstrated that the limited effects of traditional health education, a lack of professional advice regarding antihypertensive treatment, and age were related to a patient’s adherence with regular blood pressure measurement and taking medication. We also performed a quantitative study, selecting two villages in Yangzhong County as study sites. A total of 188 patients with hypertension were invited to participate in a 6-month family member-based intervention trial. The primary outcomes were the acceptability and feasibility of the intervention strategy. Secondary outcomes included medication adherence and changes in blood pressure. More than 75% of patients expressed a wish for external reminders, and 93.5% responded that they would accept the family member-based supervision. The patients preferred their spouse or a child as the supervisor. After the 6-month intervention, the proportion of patients with uncontrolled blood pressure decreased from 87.2% to 45.7%. This pilot study shows that external supervision by family members is acceptable and feasible for patients with hypertension; it also shows favorable effects with regard to improved treatment adherence and blood pressure control. Future randomized controlled trials with modified intervention measures are needed to validate this finding.

Keywords: hypertension, treatment, adherence, supervision, intervention

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