Effectiveness of a self-care education program on hypertension management in older adults discharged from cardiac-internal wards

Abstract

BACKGROUND: The aim of the present study was to determine the effectiveness of a self-care education (SCE) discharge program with telephone follow-ups in managing hypertension (HTN) in older patients. METHODS: The study was conducted on 56 older patients with HTN who had recently been discharged from the cardiac wards of hospitals in Isfahan, Iran, in 2017. Participants were randomly allocated to the intervention and control groups. The intervention was a 6o-minute SCE discharge program with 4 re-educative telephone follow-ups every 2 weeks based on 4 chapters of the designed SCE program and booklet. After coding the data and entering them into SPSS software, data were analyzed for the comparison of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) as well as frequency of managed HTN in the intervention and control groups at baseline (before discharge), and 2 and 3 months after discharge. RESULTS: Statistical tests showed no significant difference in any of the demographic and confounding variables as well as baseline BPs (P > 0.050), but at post-intervention follow-ups, after Mauchly's sphericity test, repeated measurements ANOVA showed that the effect of time (P < 0.001) and group (P = 0.043) on SBP was significant. The effect of time (P = 0.036) and group (P = 0.047) on DBP was also significant. McNemar's test showed that the frequency of managed HTN (normal BP), 3 months after discharge, was significantly higher in the intervention group compared to the control group 87.5% (n = 21) vs. 23.1% (n = 6), respectively (P < 0.001). CONCLUSION: SCE discharge program with telephone re-educative follow-ups was effective in reducing mean BP. The use of this program as a discharged plan for older adults with HTN and comparison of readmission rates for a longer period are recommended.