title: Family member-based supervision of patients with hypertension: a cluster randomized trial in rural China.
abstract: Empirical evidence has suggested that social support from family can help patients take their medicines correctly. This study aims to evaluate the role of a family member-based supervision package in the management of hypertension using a cluster randomized trial in rural China. We recruited patients with hypertension from four villages in Yangzhong and randomly allocated them to the control group (n=288) and the intervention group (n=266). A family member-based supervision package was applied to the intervention group, while the usual service was applied to the controls. Patients were followed for 12 months and completed face-to-face interviews at the end of 6 and 12 months. The primary outcomes were patients' medication adherence and frequency of blood pressure measurement. Secondary outcomes included changes in blood pressure, altered risk behaviours and occurrence of hypertension-related complications. To control for the effects of cluster randomization, multilevel mixed-effects regression models were used to compare group changes. We observed that the intervention improved patients' blood pressure measurement frequency (OR: 9.00, 95% CI: 4.52-17.91) and adherence to antihypertensive treatment (OR: 1.74, 95% CI: 0.91-3.32). Its effect on the blood pressure control rate was significant at the mid-term investigation (OR: 0.67, 95% CI: 0.40-0.93), but the long-term effect was not significant (OR: 0.89, 95% CI: 0.64-1.26). After 6 months of intervention, either systolic or diastolic blood pressure was significantly decreased in the intervention group. However, this difference was not significant at the final investigation. Findings from this study revealed that the family member-based supervised therapy may have positive effects on patients' adherence to blood monitoring and hypertensive medications.
authors.affiliation: Department of Gastrointestinal Surgery, Aoyoung Hospital, Zhangjiagang, China.|Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: X
authors.initials: X
authors.lastname: Peng
authors.affiliation: Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: M
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: X
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: G
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: L
authors.initials: L
authors.lastname: Lü
authors.affiliation: Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: K
authors.initials: K
authors.lastname: Xu
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Health Care Services, Stockholm County Council, Stockholm, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Burstrom
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Health Care Services, Stockholm County Council, Stockholm, Sweden.|Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Burstrom
authors.affiliation: Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.|Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China.|The Innovation Center for Social Risk Governance in Health, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: J
authors.initials: J
authors.lastname: Wang
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory; D005195:Family Relations; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012944:Social Support
chemical_list: D000959:Antihypertensive Agents