https://orcid.org/0000-0003-4958-6201
Abstract
Purpose: The study was conducted to investigate the effects of multimodal interventions on medication nonadherence, quality of life (QoL), hypertension (HTN), self-efficacy, and clinical outcome in terms of blood pressure (BP) among elderly people with HTN.
Methods: An experimental design using a randomized controlled trial was adopted (N=80+80). The experimental group received multimodal interventions and the control group received routine care. Both groups were followed up at baseline and at 3 and 6 months. The data collection tools of demographic and clinical proforma, structured knowledge questionnaire on HTN (r=0.84), Revised Medication Adherence Self-Efficacy Scale (r=0.94), Morisky Medication Adherence Scale (r=0.83), World Health Organization Quality of Life-BREF scale (r=0.87), and digital BP apparatus were used. Necessary administrative permission was obtained for the study.
Results: The study results proved that nurse-led multimodal interventions led to an improvement in medication adherence [F(1.75,214.30)=774.18, p<0.001], knowledge on HTN [F(2,244)=43.83, p<0.001], and self-efficacy [F(1,122)=3.99, p=0.04] of elderly people on antihypertensives over a period of 6 months. Overall QoL did not exhibit any statistically significant improvement, and no statistically significant reductions in the systolic BP (SBP) and diastolic BP (DBP) scores were obtained (p>0.05) in the experimental group over a period of 6 months. However, the clinical significance of multimodal interventions for improvements in medication adherence, QoL, knowledge on HTN, and self-efficacy was more favorable compared with the reduction in SBP and DBP scores.
Conclusion: Nurses play a crucial role in improving medication adherence among elderly people with HTN.
Trial details: Ethical clearance was obtained (IEC no. KH IEC 253/2012) from the Institutional Ethical Committee of Manipal University, Manipal, and the study was conducted in accordance with the Declaration of Helsinki. The study is registered under Clinical Trials Registry of India (CTRI/2017/04/008405). Informed consent was obtained from participants, and the confidentiality of information was assured.
Acknowledgments
This manuscript was edited by editingindia. This study was self-funded.
Abbreviations list
BP, blood pressure; DBP, diastolic blood pressure; HTN, hypertension; QOL, quality of life; SBP, systolic blood pressure; MMAS-8, Morisky Medication Adherence Scale-8; MASES-R, Revised Medication Adherence Self Efficacy Scale; WHOQOL-BREF, World Health Organization Quality of Life-BREF.
Data sharing statement
All data generated or analyzed during this study are included in this article.
Data availability
The patient information leaflet on adherence prepared both in English as well as Kannada is available with the corresponding author. Also, the datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Disclosure
The authors report no conflicts of interest in this work.