«Health school» for arterial hypertension patients: district out-patient clinic experience

Aim. To analyze effectiveness of “Health School” (First Out-Patient Department, Yekaterinburg Central City Hospital No. 6) activity in arterial hypertension (AH) patients. Material and methods. The study included 120 patients (85 females), attending School sessions. Attendees’ questionnaire survey was performed at first and sixth sessions. Target blood pressure (BP) level achievement was assessed by office BP measurement and diary BP registration. Six-month results after stopping the program were also registered. Results. Among all participants, there were 70.8% females; 67 individuals under 60 were still working (58.3%), 41 had Stage I AH (34%). By the program’s end, 30 patients (25%) achieved target BP levels; in 42 individuals (35%), BP decreased by 30% from the baseline level. Six months later, 67 patients (55.8%) maintained target BP level. Increase in combination therapy usage, by the end of the program, was associated with increased administration of diuretics and angiotensin II receptor antagonists. Conclusion. Optimal program outlay included interactive lectures and individual consultation sessions, that gave a chance to reach wide audience of AH patients and achieve real-life positive results in their treatment.

1. Балкаров И.М., Шоничев Д.Г., Козлова В.Г. и др. Некоторые подходы к повышению качества лечения пациентов с артериальной гипертонией (опыт «школы пациента с артериальной гипертонией»). Тер архив 2000; 1: 47-51.

2. Калинина А.М. Школа здоровья для пациентов с артериальной гипертонией. Качество жизни 2003; 2: 78-82.

3. Конради А.О, Соболева А.В., Максимова Т.А. и др. Обучение больных гипертонической болезнью – бессмысленная трата времени или реальный инструмент в повышении качества контроля заболевания? Артериал гиперт 2002; 8(6): 217-20.

4. Леонова М.В., Белоусов Д.Ю. Результаты фармакоэпидемиологического исследования артериальной гипертонии в России (ПИФАГОР). Кардиология 2003; 11: 23-6.

5. Оганов Р.Г., Калинина А.М., Поздняков Ю.М. и др. Организация Школ Здоровья в первичном звене здравоохранения. Организационно-методическое письмо Минздрава РФ. Москва 2002; 30 с.

6. Ощепкова Е.В. О федеральной целевой программе «Профилактика и лечение артериальной гипертонии в Российской Федерации». Профил забол укреп здор 2002; 1: 3-7.

7. Шальнова С.А. Деев А.Д., Вихирева О.В. и др. Распространенность артериальной гипертензии в России: информированность, лечение, контроль. Профил забол укреп здор 2001; 2: 3-7.

8. Шутемова Е.А., Ушакова С.Е., Концевая А.В. и др. Информированность пожилых пациентов о принципах вторичной профилактики артериальной гипертонии и готовность к участию в лечении. Кардиваск тер профил 2003; 2: 9-13.

9. Эйдельман С.Е. Фармакоэпидемиология артериальной гипертензии в Санкт-Петербурге на примере Петроградского района. Артериал гиперт 2002; 8(6): 212-6.

10. Al-Khadra A, Al-Muhana F, Ibrahim I. Patients’ knowledge of hypertension and its management. J Saudi Heart Assoc 1991; 3(3): 106-9.

11. Al-Sowielem LS, Elzubier AG. Compliance and knowledge of hypertensive patients attending PHC centres in Al-Khobar, Saudi Arabia. Bulletin of the World Health Organization 1998; 4(2): 301-7.

12. Appel LJ, Champagne CM, Harsha DW, et al. Writing Group of the PREMIER Collaborative Research Group. Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA 2003; 289(16): 2083-93.

13. Clark LT. Improving compliance and increasing control of hypertension: needs of special hypertensive populations. Am Heart J 1991; 121: 664-9.

14. Cziraky MJ. NHBPEP: working to reduce death and disability from high blood pressure. National High Blood Pressure Education Program. J Am Pharm Assoc (Wash) 2002; 42(6): 886-8.

15. Hosie J, Wikhund I. Managing hypertension in general practice: can we do better? J Human Hypertens 1995; 9(Suppl. 2): S15-8.

16. Imai Y, Tsuji I, Nagai K, et al. Ambulatory blood pressure monitoring in evaluating the prevalence of hypertension in adults in Ohasama, a rural Japanese community. Hypertens res 1996; 19(3): 207-12.

17. Khalil SA, Elzubier AG. Drug compliance among hypertensive patients in Tabuk City, Saudi Arabia. J Hypertens 1997; 15: 561-5.

18. Marilyn R. Factors associated with adherence in hypertensive patients. Annals Med 1987; 14(4): 245-8.

19. Muhlhauser I, Sawicki PT, Didjurgeit U, et al. Evaluation of a structured treatment and teaching program on hypertension in general practice. Clin experim hyperten 1993; 15: 125-42.

20. Neutel JM, Smith DH. Improving patient compliance: a major goal in the management of hypertension. J Clin Hypertens (Greenwich) 2003; 5(2): 127-32.

21. Popov AA, Izmozherova NV, Oboskalova TA, Lounegova VV. Educational programs for patients increase hormone replacement therapy compliance. 10th World Congress on the Menopause. 10-14 June 2002. Berlin, Germany. Abstr. P11-3.

22. Richardson MA, Simons-Morton B, Annegers JF. Effect of perceived barriers on compliance with antihypertensive medication. Health education quarterly 1993; 20: 489-503.

23. Sharkness CM, Snow DA. The patient’s view of hypertension and compliance. Am J Prev Med 1992; 8: 141-6.

24. Tormo MJ, Navarro C, Chirlaque MD, Perez-Flores D. Prevalence and control of arterial hypertension in the southeast of Spain: a radical but still insufficient improvement. Eur J Eepidemiol 1997; 13(3): 301-8.

25. Stanton MP, Nix GS. Effect of a hypertension teaching protocol on patient and staff satisfaction in a rural community health center. Lippincotts Case Manag 2003; 8(3): 125-32.