Title : Psychosocial approaches to effective hypertension management
Abstract:
Hypertension is one of the major global concerns because of its prevalence (about 1.28 billions across the globe) and its characteristic of being the silent killer. The asymptomatic nature of the condition makes about 46% patients, unaware of their condition resulting in only about 42% of patients having the diagnosis and treatment. If one of the major global target of NCDs to reduce hypertension by 33% by 2030, it is high time that we replace the existing biomedical approach with biopsychosocial approach. The fact that about two thirds of the hypertension patients live in low and middle income countries warrants that the researchers in these countries come up with innovative research designs targeting both optimization of disease management and designing preventive measures to address the progressive increase in the incidence of the disease. These measures should also be cost-effective in view of the disease burden and the national economic condition. A series of studies conducted on Indian sample proved the supplementation of psychosocial approach to the existing biomedical path has been effective in management of hypertension. Further studies also suggested that using children as agents optimized hypertension management in adult patients suggesting the need for out-of-the box thinking in addressing the issue of prevention.
A study was designed on 30 doctors and 300 patients to investigate if the quality of communication between the doctor and the patients had an effect on management of hypertension in the patients. The results proved a positive relationship and also indicated a clear pathway between quality of communication and prognosis via adherence to medication, diet and exercise. Subsequent study on a sample of 250 adult hypertension patients showed the role of cognitive mediation on enhanced adherence and hypertension management. This highlighted the need for knowledge base about the disease for effective management of emotions and adherence behaviour as well as self-efficacy. The third study investigated if hypertension knowledge intervention to schoolchildren proved effective in knowledge retention and if this knowledge had any inadvertent positive effect in their lifestyle. The results indicated positive change in knowledge levels as well as changes in lifestyle. Encouraged by the results a fourth study was designed to examine if schoolchildren after hypertension knowledge intervention could be used as health monitors of the adults in the families diagnosed with hypertension. Results revealed that children with some identified psychological characteristics proved to be effective health monitors of the adult family members under treatmentfor hypertension. This indicated that schoolchildren can be used as effective health agents to ensure better clinical adherence among patients with hypertension. Further, since the knowledge intervention resulted in positive change in lifestyle practices, these health young health monitors are also likely to continue healthy lifestyle that prevents hypertension in them.
