title: Patient engagement strategies used for hypertension and their influence on self-management attributes.
abstract: BACKGROUND
  Several effective methods to facilitate patient self-management of hypertension are available in primary care. These include direct support from community pharmacists and general practice, and the use of home blood pressure (BP) monitoring. The aim of this study is to establish the prevalence of use of key strategies and to determine their independent relationship with patient self-management attributes.
  
  
  METHODS
  A survey of patients with treated hypertension was undertaken in 27 community pharmacies. This established recent use of BP monitoring and advice from health professionals. Patient awareness of BP and targets, appropriateness of BP targets and adherence to anti-hypertensive medications were assessed as indicative self-management outcomes. Predictors of outcomes were determined using binary logistic regression.
  
  
  RESULTS
  Overall, 215 surveys were returned. Two-thirds of patients were aged >65 years, and 45% had conditions warranting tighter BP control (<130/80 mmHg). Almost all patients reported monitoring of their BP in the previous year and 63% could report their most recent BP reading. Just 36% reported knowing a target BP, and 78% of reported targets were within guidelines recommendations. One-fifth (22%) monitored their own BP, and 15% reported non-adherence to medication. Doctors provided the large majority of professional advice. Self-monitoring or documentation of BP readings was independently associated with increased likelihood of BP and target BP being known.
  
  
  CONCLUSIONS
  Regular monitoring of BP does not automatically translate to professional advice. Increased uptake of patient self-monitoring should be promoted as a means of enabling self-management.
authors.affiliation: Greater Green Triangle University Department of Rural Health, Flinders University and Deakin University, Warrnambool and Centre for Medicine Use and Safety, Monash University, Parkville, Australia. kevin.mcnamara@greaterhealth.org.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Mc Namara
authors.affiliation: Greater Green Triangle University Department of Rural Health, Flinders University and Deakin University, Warrnambool and.
authors.forename: Vincent L
authors.initials: VL
authors.lastname: Versace
authors.affiliation: Centre for Medicine Use and Safety, Monash University, Parkville, Australia.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Marriott
authors.affiliation: Greater Green Triangle University Department of Rural Health, Flinders University and Deakin University, Warrnambool and.
authors.forename: James A
authors.initials: JA
authors.lastname: Dunbar
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001795:Blood Pressure Determination / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation; D011320:Primary Health Care; D012648:Self Care; D011795:Surveys and Questionnaires; D014739:Victoria
chemical_list: D000959:Antihypertensive Agents
keywords: Health promotion; health behavior change; hypertension; lifestyle modification; multidisciplinary care; patient education; primary care.