The effects of social support and health professional home visits on patient adherence to hypertension regimens

The effects of social support and health professional home visits on patient adherence to hypertension regimens

ABSTRACTS: A-69 CbE BY ON-E THE BARRIERS FrZLL. Burton C. Dyson. Illinois Springfield, Illinois, HIGH BLOOD PRESSURE 155 CONTROL HYPERTENSION C...

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ABSTRACTS:

A-69 CbE BY ON-E THE BARRIERS FrZLL. Burton C. Dyson. Illinois Springfield, Illinois,

HIGH

BLOOD

PRESSURE

155

CONTROL

HYPERTENSION CONTROL IN TLLINOIS

lkpnrtwnt 62761, Byron

of Public J. Fr;lncis;

Health. Gerald

535 t‘. Jefferson, K, Lrw; )ls. Edith

G. Rcide.

The enrollment of everv hypertensive in ?n effective nhysicinn directed ?rimarv care facility, also advised by the local public health n=ency, :-isitlv :lould reduce 10~1 rates of strokes and heart attacks. Five obstacles block this practical vision: (a) limited engagement of physician groups in pooulatinn based plannlnp, (b) neglected use of paraprofessionals. Cc) ineffective natient r&cation, (d) limited surveill.znce tooIs in some conmunities, (e) ineffective lonp term follow-:lp. To ren*ove these obstacles in 1977, we used grants to help selected local health agencies move from clinical treatment of the few to casefindin?, referrn? and nonitoring of the maw. In 1978 our grants were directed nt improving their community surveillance and record keeping for other local ??encics interested in cnsefinding, treatment, and patient education. In 1.978 and 1979 we wfll develop local hospital reporting of populntion based rates of stro!tes 2nd heart attac!:s rls a tool for locally funded coordination of continuous comarehensive prSmarv services to all hypertensives. By limiting our spending to the epfdemiolo*tcal.ly directed coorr1inntin.e work of local nublic health nzencies, x.-e expect existin,? private sector agencies to develop service comnonents shown to he 9isslnl: in so-e poprll?tiow.

A-70 THE EFFECTS OF SOCIAL SUPPORT AND HEALTH PROFESSIONAL HOME VISITS ON PATIENT ADHERENCE TO HYPERTENSION REGIMENS University Jo Anne L. Earp, School of Public Health, Hill, North Carolina 27514; Marcia G. Ory.

of

North

Carolina,

Chapel

To test the utility of directed social support as an adjunct to medical care, 218 Group A received standhypertensive patients were randomly allocated to 3 groups. ard clinic care and home visits by health professionals (public health nurses and In addition a "significant other" pharmacists). (relative or friend selected by the patient) measured the patient's blood pressure on a regular basis for 18 Group C (Control) remonths. Group B received both usual care and home visits. The interventions' effectiveness in promoting ceived standard clinic care only. adherence to hypertension regimens was measured in several ways including patient The analysis to date has used a blood presself-reports at the end of the trial. from entry-level diastolic BP at four time periods over a sure measure, reduction 24 month interval. It reveals the following: 1) DBP declined in all groups during the trial; 2) at 18 months (the end of the visiting) the decline in DBP was in Group B (6 mmHg) and least in the greatest in Group A (9 nnnHg), intermediate was statistically significant for control Group C (5 mmHg); 3) while the reduction in the control group was limited to female all 3 groups at 18 months, the decline patients; 4) only for Group A patients was a statistically significant decrease in the visiting had DBP (8 mmHg, p<.OOO) sustained at 24 months, six months after ceased; 5) little difference was observed between patients visited by nurses versus The results indicate that the involvement of a significant other in pharmacists. in conjunction with the benefits of home the management of hypertension regimens, visits by health professionals irregardless of the latter's type training, iS more and that both support strategies are superior effective than home visiting alone, to usual clinic care in increasing patient compliance.