Patient‐tailored self‐management intervention for older adults with hypertension in a nursing home

Aims and objectives. This study was to evaluate the effects of a patient‐tailored self‐management intervention on (1) blood pressure control and (2) self‐care behaviour, exercise self‐efficacy and medication adherence among Korean older hypertensive patients in a nursing home. Background. Little is known about whether a patient‐tailored self‐management for nursing home residents with hypertension is likely to advance the care of this growing population worldwide. Design. A non‐equivalent comparison group design. Methods. Forty‐seven patients (23 and 24 in the intervention and comparison groups, respectively) participated in the study. No one withdrew during the eight‐week study period. Hypertensive patients in the intervention group received health education and tailored individual counselling for eight weeks to enhance the self‐management. Results. The mean age of patients was 77·4 years. Patients were on hypertensive medications for 11·8 years; only 36 of them took medications without assistance. The baseline comparisons of the patients with and without 8‐week intervention did not differ for clinical and demographic variables and outcome measures. Blood pressure decreased when comparing the baseline to eight weeks later from baseline; moreover, blood pressure was significantly reduced only in patients who received the intervention. Self‐care behaviour and exercise self‐efficacy significantly increased over time only in those who were in the intervention group. However, no significant difference was observed in medication adherence between the two groups. Conclusions. Patient‐tailored self‐management intervention was a practical approach for decreasing blood pressure and increasing self‐care behaviour in older hypertensive patients in a nursing home. Further studies are needed to validate these findings using a larger sample with long‐term follow‐up. Relevance to clinical practice. A patient‐tailored intervention is feasible not only to empower nursing home residents with hypertension for their care, but also to offer a qualified training and guidelines to nursing home staffs, expanding their professional competence in clinical practice.