Impact Of Trans-theoretical Model Based Home Visiting On Medication Behavior For Elderly Hypertensive Patients In Residential Aged-care Facility

Objective:To explore the effect of stage-matched trans-theoretical model-based intervention on medication management for hypertensive elderly.Methods:This study was a randomized controlled trial with 120 hypertensive elderly patients conducted in a residential aged-care facility,patients were randomly assigned to intervention group(n=60)and control group(n=60).The intervention included patient education,face-to-face stage-matched consultations and centralized meeting.Medication stage of change,self-efficiency for appropriate medication use,patient activation and blood pressure were tested at baseline,3-and 6-months.Results:Our results showed that the intervention group demonstrated a significant greater improvement in stage of change of medication after six-month(Z=-4.60,p<0.001),medication refill and adherence after three-month(t=-15.53;p<0.001)and six-month(t=-13.67;p<0.001),level of self-efficiency after three-month(B=2.585;95%CI=1.63,3.54;p<0.001)and six-month(B=4.03;95%CI=3.05,5.01;p<0.001),patient activation after three-month(Z=-6.90,p<0.001)and six-month(Z=-7.75,p<0.001),and blood pressure control after six month(t=-2.92,p<0.05)compared to control group.Conclusion:This study revealed that six-month trans-theoretical model based stage-matched intervention had significant positive effect on medication management for the hypertensive elderly residents in the aged-care facility.Better blood pressure control,higher level of medication refill and adherence,self-efficiency as well as patient activation were observed for all level stage of change at baseline.Practice implications:trans-theoretical model based intervention could help elderly patients to achieve a better blood pressure control in short term,modern technology may be incorporated to improve self-management of blood pressure in long term.