Hypertension management: what is the role of case management?

Objective The aim of this study was to determine the effect of case management on hypertension management and on adherence to antihypertensive medication and chronic disease care of patients with hypertension. Method This study was conducted as an experimental and randomized controlled study. The sample of the study consisted of randomly selected patients with hypertension who did not have communication problems, who used antihypertensive medication treatment and whose treatment had been continuing for at least six months. The study group was given individual training (Hypertension causes, the risk factors, significance, unwanted side effects, medication treatment, changes in life style) and was applied case management model in hypertension - joint care protocol but no intervention was offered to the control group. Data was collected using the adherence to antihypertensive medication scale, the patient assessment of chronic illness care in the first and six months later interview. Results There was no significant difference between the study and control group according to adherence to antihypertensive medication and patient assessment of chronic illness care in the first interview. Otherwise, there were significant differences between the study and control group according to blood pressure, adherence to antihypertensive medication and patient assessment of chronic illness care in the six months later interview. The adherence to antihypertensive medication total score and the patient assessment of chronic illness care total score were significantly higher in the study group compared with control group in the six months later interview. Conclusion The case management plays an important role the in control of hypertension, and can improve adherence to antihypertensive medication and chronic illness care.

Hypertension management: what is the role of case management? / Manejo da hipertensão: qual é o papel do manejo de caso? / Manejo de la hipertensión: ¿cuál es el papel del manejo de caso?

ABSTRACT Objective The aim of this study was to determine the effect of case management on hypertension management and on adherence to antihypertensive medication and chronic disease care of patients with hypertension. Method This study was conducted as an experimental and randomized controlled study. The sample of the study consisted of randomly selected patients with hypertension who did not have communication problems, who used antihypertensive medication treatment and whose treatment had been continuing for at least six months. The study group was given individual training (Hypertension causes, the risk factors, significance, unwanted side effects, medication treatment, changes in life style) and was applied case management model in hypertension - joint care protocol but no intervention was offered to the control group. Data was collected using the adherence to antihypertensive medication scale, the patient assessment of chronic illness care in the first and six months later interview. Results There was no significant difference between the study and control group according to adherence to antihypertensive medication and patient assessment of chronic illness care in the first interview. Otherwise, there were significant differences between the study and control group according to blood pressure, adherence to antihypertensive medication and patient assessment of chronic illness care in the six months later interview. The adherence to antihypertensive medication total score and the patient assessment of chronic illness care total score were significantly higher in the study group compared with control group in the six months later interview. Conclusion The case management plays an important role the in control of hypertension, and can improve adherence to antihypertensive medication and chronic illness care.

RESUMO Objetivo Determinar o efeito do manejo de caso sobre o manejo da hipertensão e sobre a adesão à medicação anti-hipertensiva e à assistência às doenças crônicas de pacientes com hipertensão. Método Estudo experimental, controlado e randomizado. A amostra consistiu de pacientes com hipertensão, selecionados aleatoriamente, que não tivessem problemas de comunicação, usassem tratamento com medicação anti-hipertensiva e cujo tratamento estive sendo realizado por pelo menos seis meses. Foi dado treinamento individual ao grupo de estudo (causas da hipertensão, fatores de risco, significância, efeitos colaterais indesejados, tratamento medicamentoso, mudanças no estilo de vida) e foi aplicado modelo de manejo de caso em hipertensão - protocolo de assistência coletiva, mas nenhuma intervenção foi oferecida ao grupo de controle. Os dados foram coletados usando a adesão à escala de medicação anti-hipertensiva, a avaliação do paciente para a assistência às doenças crônicas na primeira entrevista e na de depois de seis meses. Resultados Não houve diferença significativa entre o grupo de estudo e o grupo de controle no que se refere à adesão à medicação anti-hipertensiva e à avaliação do paciente para assistência às doenças crônicas na primeira entrevista. No entanto, houve diferenças significativas entre o grupo de estudo e o grupo controle no que se refere à pressão sanguínea, adesão à medicação anti-hipertensiva e avaliação do paciente para assistência às doenças crônicas na entrevista de depois de seis meses. O score total de adesão à medicação anti-hipertensiva e o score total de avaliação do paciente para assistência às doenças crônicas foram significativamente maiores no grupo de estudo comparados com o grupo de controle na entrevista de após seis meses. Conclusão O manejo de caso tem um papel importante no controle da hipertensão e pode melhorar a adesão à medicação anti-hipertensiva e a assistência às doenças crônicas.

RESUMEN Objetivo Determinar el efecto del manejo de caso sobre el manejo de la hipertensión y la adhesión a la medicación antihipertensiva y a la asistencia a las enfermedades crónicas de pacientes con hipertensión. Método Estudio controlado, randomizado y experimental. La muestra consistió de pacientes con hipertensión seleccionados aleatoriamente, quienes no tenían problemas de comunicación, usaban tratamiento con fármacos antihipertensivos y cuyo tratamiento se estaba realizando durante por lo menos seis meses. Se proporcionó entrenamiento individual al grupo de estudio (causas de la hipertensión, factores de riesgo, significación, efectos colaterales indeseados, tratamiento medicamentoso, cambios en el estilo de vida) y fue aplicado modelo de manejo de caso en hipertensión -protocolo de acción colectiva, pero ninguna intervención fue ofrecida al grupo control. Los datos fueron recogidos utilizándose la adhesión a la escala de medicación antihipertensiva, la evaluación del paciente para asistencia a las enfermedades crónicas en la primera entrevista y en la entrevista de después de seis meses. Resultados No hubo diferencia significativa entre el grupo de estudio y el grupo control en lo que se refiere a la adhesión a la medicación antihipertensiva y la evaluación del paciente para la asistencia a las enfermedades crónicas en la primera entrevista. Sin embargo, hubo diferencias significativas entre el grupo de estudio y el grupo control en lo que se refiere a la presión sanguínea, adhesión a la medicación antihipertensiva y evaluación del paciente para la asistencia a las enfermedades crónicas en la entrevista tras seis meses. El puntaje total de la adhesión a la medicación antihipertensiva y el puntaje total de la evaluación del paciente para asistencia a las enfermedades crónicas fueron significativamente mayores en el grupo de estudio comparados con el grupo control en la entrevista tras seis meses. Conclusión El manejo de caso juega un rol importante en el control de la hipertensión y puede mejorar la adhesión a la medicación antihipertensiva y a la asistencia a las enfermedades crónicas.