Vol 10, No 5 (2006)
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Published online: 2006-09-13

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How to treat hypertension more effectively? Patients’ education program in Polish Project of 400 Cities

Radosław Szczęch, Anna Szyndler, Łukasz Wierucki, Tomasz Zdrojewski, Krzysztof Narkiewicz, Bogdan Wyrzykowski w imieniu Kierownictw Miast
Nadciśnienie tętnicze 2006;10(5):350-361.

Abstract

Background Hypertension is the most common cardiovascular pathology. Treatment efficacy, despite effective methods, is still highly unsatisfactory. Hypertensive patients are at high risk of cardiovascular complications. One of the reasons for treatment poor effects is lack of patient-doctor cooperation. PP400M is multicenter, intervention and research project which aim was to improve efficacy of screening and reduction of major cardiovascular risk factors and improvement of healthy diet knowledge. The aim of the study was to evaluate effectiveness of educational program designed for newly diagnosed patients with hypertension, dyslipidaemia and glucose intolerance.
Material and methods In 268 small cities and villages of up to 8000 habitants in years 2003-2005 the educational program was implemented. 10 720 patients with newly diagnosed metabolic disturbances were invited to participate in education program. The meetings were held by teams of nurse and a physician. The eight people groups met during two meetings, held weekly. The first meeting was devoted to risk factors, diet and self blood pressure measurement, during second meeting the rules of hypertension pharmacotherapy were discussed. Teams instructed to implement the program were given free educational materials to continue with the program later. Participants in education meetings 66.39% were women and 33.61% men. The efficacy analysis was performed on 10 720 patients (mean age 59.39 ± 13.2 ys., BMI 27.95 ± 5.13 kg/m2, mean RR 147.75 ± 27.393/90.82 ± 13.602 mm Hg).
Results Most patients (91%) with newly diagnosed hypertension expect to be offered more information on cardiovascular diseases, only 9% asses their knowledge as good. After education meetings most of the patients (90.77%) want to be involved in treatment process, and declare the will to perform blood pressure measurement at home (92.52%). More than 90% of patients realize that home blood pressure measurement is important in hypertension management. After education knowledge level on risk factors increases as well as awareness on importance of lifestyle modification in treatment of hypertension. After education there is a marked improvement in knowledge on hypertension pharmacotherapy rules. We also observed increase of side effects awareness among patients after education meetings.
Conclusions There is a strong need for information concerning cardiovascular diseases among newly diagnosed patients with hypertension, dyslipidaemia and glucose intolerance. Newly diagnosed patients identify well cardiovascular risk factors, but knowledge about pharmacotherapy rules is very poor. Patient education is an effective tool in improving patients knowledge on disease, risk factors and methods of therapy.

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