The Effect of Training on Knowledge, Attitude, and Practice in Patients with Hypertension; The Application of the Expanded Chronic Care Model: A Clinical Trial Study

Abstract

Background: Patients have a significant role in controlling and treating hypertension. Improving patients' Knowledge, Attitude, and Practice (KAP) is a crucial step in controlling hypertension. Objectives: This study aimed to examine the effect of training based on the Expanded Chronic Care Model (ECCM) on KAP in patients with hypertension residing in Isfahan, Iran. Methods: The clinical trial was conducted on 190 hypertensive patients aged 36 to 80 in 2015 - 2016. Patients were randomly assigned to an intervention and a control group. The intervention plan based on ECCM was four 2-hour education sessions for the intervention group and a family member. Then, follow-ups were done by a phone call for six months. Meanwhile; there was no intervention in the control group. The data collection was done using KAP (a valid researcher-made questionnaire), before and after intervention in both groups. Results: In the intervention group, there was a statistically significant difference between the mean score of KAP before and six months after the ECCM training (P < 0.05). No significant differences were observed in the control group. The two groups were not significantly different in terms of the Mean +/- SD of KAP scores before the intervention. Six months after implementing the care model, however, the Mean +/- SD of KAP scores were significantly higher in the intervention group compared to in the controls (P < 0.05). Conclusions: Based on the results, a training program based on the ECCM is effective in improving the knowledge, attitude, and practice of patients. The ECCM could therefore be used as a framework for designing educational interventions for patients with hypertension.