Patient Empowerment Through Community-Based Hypertension Educational Programme in the West of Ireland

Hypertension is an increasingly prevalent condition in Ireland, affecting in excess of 50% of those over 50 years of age. While many of them undergo adequate clinical treatment, the standard of blood pressure control still remains sub-optimal mainly due to poor medication adherence fuelled by poor awareness level. The main objective of the study was to explore the impact of a structured hypertension educational intervention on patient knowledge, lifestyle behaviours and blood pressure control. Subjects for this study were recruited from disadvantaged/underserved communities in Mayo, Ireland. A multidisciplinary team comprising of specialist nurses, physiotherapist, dietitian, cardiovascular consultants and research assistants were responsible for screening and recruiting participants, collecting patient data and delivering the educational programme. Eligible participants (adults of 40 years and older) with high blood pressure were randomly assigned to either a control group or an intervention group. The control group were given standard care which included blood pressure and body mass index (BMI) measurements, lifestyle guidance and referral to general practitioner in accordance with European Society of Cardiology (ESC) guidelines. The interventional group received an educational session to improve knowledge and understanding of hypertension. A follow-up assessment was conducted for all participants 4–6 months after the educational interventional programme. A total of 102 participants were included in this study. Baseline records showed no significant difference in gender proportion, mean age, mean BMI, mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) between control and intervention groups. At the follow-up assessment, a statistical reduction of mean SBP (p=0.007) and mean DBP (p=0.004) was observed in the intervention group in comparison to baseline records along with a significant increase in self-reported weekly exercise time, reduction in the number of active smokers and units of alcohol consumed weekly. Intervention group subjects had greater blood pressure reductions (mean decrease in mmHg and absolute percentage reduction) compared to control group subjects for each of the four blood pressure indicators. Providing a tailored education to individuals with hypertension can positively impact on hypertension control, knowledge and self-care management within community-based settings.