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Effectiveness of self-management support in maintenance haemodialysis patients with hypertension: A pilot cluster randomized controlled trial.
- Source :
-
Nephrology (Carlton, Vic.) [Nephrology (Carlton)] 2018 Aug; Vol. 23 (8), pp. 755-763. - Publication Year :
- 2018
-
Abstract
- Aim: Uncontrolled hypertension is an independent risk factor for cardiovascular disease and is the leading cause of mortality in haemodialysis patients. The aim of this study was to examine the effectiveness of self-management support (SMS) for blood pressure (BP) control and health behaviours.<br />Methods: We conducted a cluster randomized controlled trial (RCT) in which 90 adult haemodialysis patients were assigned to either an SMS or common intervention (CI) group. The SMS group received an intervention consisting of self-management education and motivational interviewing. The CI group received standard care and routine health education. The primary outcome was the BP monitored before each haemodialysis. Secondary outcomes included salt intake (measured using a balance formula), home BP monitoring (HBPM) (assessed using two self-administered questions), and medication adherence (measured using the Medication-taking Behavior Scale). Data were collected at baseline and at 1, 3 and 6 months post-intervention.<br />Results: The SMS group showed continuous reductions in systolic BP from baseline: -9.2, -8.7, and -8.4 mmHg at 1, 3 and 6 months after the intervention, respectively (P < 0.01). Compared with the CI group, the SMS group had a greater decrease in systolic BP at 1 month: -5.9 mmHg (P = 0.0388), but no significant difference was found at 3 or 6 months (P > 0.05). SMS patients showed an improvement in health behaviours relative to baseline (less salt intake, more consistent HBPM, and greater medication adherence) (P < 0.05).<br />Conclusions: Self-management support obtained short-term success in improving salt restriction, regular performance of HBPM and medication adherence, which led to better BP control.<br /> (© 2017 Asian Pacific Society of Nephrology.)
- Subjects :
- Adult
Aged
Antihypertensive Agents therapeutic use
Blood Pressure Monitoring, Ambulatory
China
Diet, Sodium-Restricted
Female
Health Knowledge, Attitudes, Practice
Humans
Hypertension diagnosis
Hypertension physiopathology
Hypertension psychology
Kidney Diseases diagnosis
Kidney Diseases physiopathology
Kidney Diseases psychology
Male
Medication Adherence
Middle Aged
Pilot Projects
Sodium Chloride, Dietary administration & dosage
Sodium Chloride, Dietary adverse effects
Surveys and Questionnaires
Time Factors
Treatment Outcome
Blood Pressure drug effects
Hypertension therapy
Kidney Diseases therapy
Motivational Interviewing
Patient Education as Topic
Renal Dialysis adverse effects
Self Care methods
Subjects
Details
- Language :
- English
- ISSN :
- 1440-1797
- Volume :
- 23
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Nephrology (Carlton, Vic.)
- Publication Type :
- Academic Journal
- Accession number :
- 28666310
- Full Text :
- https://doi.org/10.1111/nep.13098