Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of a hypertension-based patient education program in a stroke center

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background The benefits of educational programs are recognized in chronic diseases. An education program was designed in our hospital, for hypertensive patients after an acute episode of stroke to prevent stroke recurrence. Objective Evaluate the effects of such program on patient knowledge and blood pressure management. Setting The 12-bed stroke center of the Groupe Hospitalier Paris Saint-Joseph, France. Method An individual educational session was provided to all the patients by the pharmacist a few days after admission. The effectiveness of the session was evaluated using a questionnaire completed by each patient before and after education. The patients had to identify the correct responses and to judge their answer’s self-confidence. The answers were ranked based on their accuracy and the surety of the respondent. Reported medication adherence and self-measurement of blood pressure were analyzed as part of the survey. Patient satisfaction with the intervention was also measured by means of a separate questionnaire. Main outcome measure Evolution of response correctness and self-confidence as well as medication adherence and blood pressure self-measurement practice. Results 64 patients were enrolled. Correct response rate increased from 77.9 to 94.1% and the absolutely sure response rate raised from 52.9 to 80.8%. Patient self-confidence was improved mainly for correct responses. Patients reported a better medication adherence and a more frequent practice of blood pressure self-measurement. They were highly satisfied. A negative correlation was found between knowledge evolution and baseline knowledge. Conclusion Education can improve stroke patient knowledge, which may enhance medication adherence and blood pressure control. Such programs should be developed even early after a stroke.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31:1281–357.

    Article  CAS  Google Scholar 

  2. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507–20.

    Article  CAS  Google Scholar 

  3. WHO | Global status report on noncommunicable diseases 2010. WHO n.d. http://www.who.int/nmh/publications/ncd_report2010/en/. Accessed 6 May 2017.

  4. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet Lond Engl. 2012;380:2224–60.

    Article  Google Scholar 

  5. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet Lond Engl. 2002;360:1903–13.

    Article  Google Scholar 

  6. Rapsomaniki E, Timmis A, George J, Pujades-Rodriguez M, Shah AD, Denaxas S, et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1·25 million people. Lancet Lond Engl. 2014;383:1899–911.

    Article  Google Scholar 

  7. Huang Y, Cai X, Zhang J, Mai W, Wang S, Hu Y, et al. Prehypertension and Incidence of ESRD: a systematic review and meta-analysis. Am J Kidney Dis Off J Natl Kidney Found. 2014;63:76–83.

    Article  Google Scholar 

  8. Musini VM, Tejani AM, Bassett K, Wright JM. Pharmacotherapy for hypertension in the elderly. Cochrane Database Syst Rev. 2009. https://doi.org/10.1002/14651858.CD000028.pub2.

    Article  PubMed  Google Scholar 

  9. Lawes CMM, Bennett DA, Feigin VL, Rodgers A. Blood pressure and stroke: an overview of published reviews. Stroke. 2004;35:1024.

    Article  Google Scholar 

  10. Krousel-Wood MA, Muntner P, Islam T, Morisky DE, Webber LS. Barriers to and determinants of medication adherence in hypertension management: perspective of the cohort study of medication adherence among older adults. Med Clin North Am. 2009;93:753–69.

    Article  Google Scholar 

  11. Therapeutic patient education: continuing education programmes for health care providers in the field of prevention of chronic diseases: report of a WHO working group - E63674.pdf n.d. http://apps.who.int/iris/bitstream/10665/108151/1/E63674.pdf. Accessed 1 May 2017.

  12. Konrady AO, Brodskaya IS, Soboleva AV, Polunicheva YV. Benefits of the implementation of structured educational program in hypertension management. Med Sci Monit. 2001;7(3):397–402.

    CAS  PubMed  Google Scholar 

  13. Babaee Beigi MA, Zibaeenezhad MJ, Aghasadeghi K, Jokar A, Shekarforoush S, Khazraei H. The effect of educational programs on hypertension management. Int Cardiovasc Res J. 2014;8:94–8.

    PubMed  PubMed Central  Google Scholar 

  14. Lu CH, Tang ST, Lei YX, Zhang MQ, Lin WQ, Ding SH, et al. Community-based interventions in hypertensive patients: a comparison of three health education strategies. BMC Pub Health. 2015;15:33.

    Article  Google Scholar 

  15. Li C, Engström G, Hedblad B, Berglund G, Janzon L. Blood pressure control and risk of stroke. Stroke. 2005;36:725–30.

    Article  Google Scholar 

  16. Weitgasser R, Clodi M, Cvach S, Grafinger P, Lechleitner M, Howorka K, et al. Diabetes education in adult diabetic patients. Wien Klin Wochenschr. 2016;128(Suppl 2):S146–50.

    Article  Google Scholar 

  17. Koelling TM, Johnson ML, Cody RJ, Aaronson KD. Discharge education improves clinical outcomes in patients with chronic heart failure. Circulation. 2005;111:179–85.

    Article  Google Scholar 

  18. Cadilhac DA, Kilkenny MF, Johnson R, Wilkinson B, Amatya B, Lalor E. The Know Your Numbers (KYN) program 2008 to 2010: impact on knowledge and health promotion behavior among participants. Int J Stroke. 2015;10:110–6.

    Article  Google Scholar 

  19. Araújo-Girão AL, Martins de Oliveira GY, Gomes EB, Parente-Arruda L, Aires de Freitas CH. The interaction in clinical nursing education: reflections on care of the person with hypertension. Rev Salud Publica Bogota Colomb. 2015;17:47–60.

    Article  Google Scholar 

  20. Maasland L, Brouwer-Goossensen D, den Hertog HM, Koudstaal PJ, Dippel DWJ. Health education in patients with a recent stroke or transient ischaemic attack: a comprehensive review. Int J Stroke. 2011;6:67–74.

    Article  Google Scholar 

  21. Alexander M, Gordon NP, Davis CC, Chen RS. Patient knowledge and awareness of hypertension is suboptimal: results from a large health maintenance organization. J Clin Hypertens Greenwich Conn. 2003;5:254–60.

    Article  Google Scholar 

  22. La Leclercq D. connaissance partielle chez le patient: pourquoi et comment la mesurer. Educ Ther Patient. 2009;1(2):S201–12.

    Article  Google Scholar 

  23. Bruttomesso D, Costa S, Dal Pos M, Crazzolara D, Realdi G, Tiengo A, et al. Educating diabetic patients about insulin use: changes over time in certainty and correctness of knowledge. Diabetes Metab. 2006;32:256–61.

    Article  CAS  Google Scholar 

  24. Brunie V, Lott MC, Guiader J, Slama M, Rieutord A, Vignand-Courtin C. Therapeutic patient education in heart failure: a program’s assessment. Ann Cardiol Angeiol (Paris). 2012;61:74–80.

    Article  CAS  Google Scholar 

  25. Matthes J, Albus C. Improving adherence with medication: a selective literature review based on the example of hypertension treatment. Dtsch Arzteblatt Int. 2014;111:41–7.

    Google Scholar 

  26. Sackett D, Gibson E, Taylor DW, Haynes RB, Hackett B, Roberts R, et al. Randomised clinical trial of strategies for improving medication medication adherence in primary hypertension. Lancet. 1975;305:1205–7.

    Article  Google Scholar 

  27. Saounatsou M, Patsi O, Fasoi G, Stylianou M, Kavga A, Economou O, et al. The influence of the hypertensive patient’s education in medication adherence with their medication. Pub Health Nurs. 2001;18:436–42.

    Article  CAS  Google Scholar 

  28. Tang KL, Quan H, Rabi DM. Measuring medication adherence in patients with incident hypertension: a retrospective cohort study. BMC Health Serv Res. 2017;17:135.

    Article  Google Scholar 

  29. Bramley TJ, Gerbino PP, Nightengale BS, Frech-Tamas F. Relationship of blood pressure control to adherence with antihypertensive monotherapy in 13 managed care organizations. J Manag Care Pharm JMCP. 2006;12:239–45.

    PubMed  Google Scholar 

  30. Lawes CMM, Vander Hoorn S, Rodgers A, International Society of Hypertension. Global burden of blood-pressure-related disease, 2001. Lancet Lond Engl. 2008;371:1513–8.

    Article  Google Scholar 

  31. Chalmers J. Global impact of stroke. Heart Dis. 2000;2(2):S13–7.

    CAS  PubMed  Google Scholar 

  32. Arima H, Chalmers J. PROGRESS: prevention of recurrent stroke. J Clin Hypertens. 2011;13:693–702.

    Article  CAS  Google Scholar 

  33. Morgado M, Rolo S, Castelo-Branco M. Pharmacist intervention program to enhance hypertension control: a randomised controlled trial. Int J Clin Pharm. 2011;33:132–40.

    Article  Google Scholar 

Download references

Acknowledgements

The authors are grateful to Anca Petre and Nicolas Greliche for their assistance in writing this paper.

Funding

None.

Conflicts of interest

None.

Open access

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Author information

Author notes

  1. Yvonnick Bezie and Mathieu Zuber have contributed equally to this work.

Authors and Affiliations

  1. Pharmacy Department, Groupe hospitalier Paris Saint-Joseph, Paris, France

    Nesrine Ben Nasr, Anne Rouault, Nicolas Cornillet, Isabelle Tersen & Yvonnick Bezie

  2. Neurology Department, Groupe hospitalier Paris Saint-Joseph, Paris, France

    Marie Bruandet & Mathieu Zuber

  3. Clinical Research Center, Groupe hospitalier Paris Saint-Joseph, Paris, France

    Hélène Beaussier

  4. INSERM UMR-S U1237, GIP Cycéron, Caen, France

    Mathieu Zuber

Authors
  1. Nesrine Ben Nasr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anne Rouault
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nicolas Cornillet
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marie Bruandet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hélène Beaussier
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Isabelle Tersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yvonnick Bezie
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mathieu Zuber
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nesrine Ben Nasr.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ben Nasr, N., Rouault, A., Cornillet, N. et al. Evaluation of a hypertension-based patient education program in a stroke center. Int J Clin Pharm 40, 1490–1500 (2018). https://doi.org/10.1007/s11096-018-0745-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-018-0745-2

Keywords

Search

Navigation