EFFECTIVENESS OF A HYBRID NURSE-LED SELF-MANAGEMENT MODEL ON MEDICATION ADHERENCE AND BLOOD PRESSURE REDUCTION IN PATIENTS WITH HYPERTENSION

Abstract

Hypertension is a chronic health condition that requires sustained medication adherence and effective disease self-management. Nurse-led interventions integrating face-to-face education and digital support may improve medication adherence and clinical outcomes among patients with hypertension. This study aimed to evaluate the effectiveness of a hybrid nurse-led self-management model in improving medication adherence and reducing blood pressure among patients with hypertension. A quasi-experimental study with a pretest–posttest control group design was conducted involving 60 patients with hypertension, comprising 30 participants in the intervention group and 30 in the control group. The intervention group received two structured nurse-led educational sessions, a digital self-management pocketbook, and weekly follow-up support over eight weeks, while the control group received standard care. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8), and blood pressure was measured using a calibrated digital sphygmomanometer. The mean medication adherence score in the intervention group increased from 5.1 to 7.3, compared with an increase from 5.0 to 5.6 in the control group. Mean systolic blood pressure in the intervention group decreased from 152.4 to 138.1 mmHg, while diastolic blood pressure decreased from 94.3 to 86.2 mmHg. At post-intervention assessment, the intervention group demonstrated significantly higher medication adherence scores and lower systolic and diastolic blood pressure than the control group (p < 0.01). These findings suggest that the hybrid nurse-led self-management model may be an effective approach to improving medication adherence and reducing blood pressure among patients with hypertension in primary healthcare settings.