Counseling and motivational short text messages increase adherence and behavioral changes in patient with hypertension
Abstract: Patients with
hypertension often fail to achieve treatment goals of controlling their blood
pressure, hence they fall onto the condition of uncontrolled hypertension. In
addition to counseling and patient-education programme, an enhanced methods of
intervention is needed by pharmacist to increase patient adherence and
commitment in taking antihypertension medicine. Motivational intervention has
not been widely used by pharmacist in conducting pharmaceutical care to
patients.
Objective: This research is aimed to understand the effect of
motivational counseling and short text messages (SMS) with adherence and
behavioral changes in outpatient with hypertension at PKU Muhammadiyah Hospital
Bantul, Yogyakarta.
Methods: Sixty patients who meet the inclusion criteria was divided into
two groups, which were experimental group (n=30) who received motivational counseling
and SMS, and control group (n=30) who received usual care. Data was collected
by interviews, behavioral questionaire, adherence questionaire using Morisky
Medication Adherence Scale (MMAS), and blood pressure measurement according to
the medical record.
Results: Trans theoretical model (TTM) was used in this research. Stages of
behavioral changes were divided into pre-contemplation, contemplation, preparation,
and action. Result showed that pharmacist intervention, using motivational
counseling and SMS as reminder, contribute to an increase of patient adherence
and action stage of behavioral changes in the experimental group by 50%
compared to 20% in the control group (p=0,035). Increase of adherence as much
as 83,33% was seen in experimental group (p=0,000). A bigger decrease of
systolic and diastolic blood pressure (SBP/DBP) was also seen in the
experimental group compared to control group (SBP=15,37 vs 1,27mmHg), (DBP=6,73
vs 0,43 mmHg) on their second visits.
Conclusion: Based on these results, it can be concluded that motivational
counseling with SMS as a reminder and motivation by pharmacists in hypertensive
patients give a positive influence on behavioral changes that improve
adherence, and increase of systolic and diastolic blood pressure control.
Author: Zukhruf Ginanjar
Saputri, Akrom, Endang Darmawan
Journal Code: jpkedokterangg160161