Promotion of behavioural change in people with hypertension: an intervention study.
OBJECTIVE
To assess the efficacy of a comprehensive motivational approach in reducing blood pressure in Italian patients with hypertension.


METHODS
Two hundred and ninety-two first visit patients with hypertension without diabetes and dyslipidemia and with BMI < 28 were enrolled. One hundred and forty-two were randomly assigned to a Control group (C) and 150 to an Intervention group (I). A ten-multiple-choice questionnaire was developed to evaluate the effect of the intervention on lifestyle modification. Patients were given the questionnaire, had their BP measured and drug therapy registered before educational intervention and 12 months later. Group I patients participated in the focus group and in the role play 2 and 4 months, respectively, after recruitment. Group C patients received the oral information.


METHODS
Blood pressure values and lifestyle modification. An intention to treat analysis was undertaken. Analysis was performed using SPSS version 15.0.


RESULTS
Of the 150 group I patients, 58 participated in both focus group and role play, 30 participated only in focus group and the remaining 62 never participated. After 12 months, there was a significant reduction of BP for group I (P < 0.001) and a significant reduction only for systolic BP in group C (P = 0.01). Diastolic BP and systolic BP decreased more markedly in group I than in group C, with P < 0.001 for both. We found a significant improvement of lifestyle modification after 12 months of follow-up concerning some aspects in both groups.


CONCLUSIONS
Our findings show that a motivational approach is a powerful tool for achieving better blood pressure control and is an essential skill for all healthcare professionals.
Scala
Daniela
D
Centre of Biotechnologies, Cardarelli Hospital, A.O. Cardarelli Via Cardarelli, 9, 80131 Naples, Italy. daniela.scala@ospedalecardarelli.it
D'Avino
Maria
M
Cozzolino
Santolo
S
Mancini
Antonio
A
Andria
Barbara
B
Caruso
Giuseppe
G
Tajana
Gianfranco
G
Caruso
Domenico
D
D000368:Aged; D001794:Blood Pressure; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009042:Motivation; D012381:Role Playing; D011795:Surveys and Questionnaires