Improving Patient Education on Blood Pressure Management in a Medically-Underserved Primary Care Clinic

Abstract

Purpose: To develop and implement a hypertension educational tool to increase hypertensionliteracy amongst patients at an urban underserved primary care practice. A quality improvement project aimed to increase patient knowledge, reduce adverse health outcomes and promote blood pressure self-management. Background: Hypertension is the strongest modifiable risk factor for cardiovascular disease and one of the most pervasive chronic diseases affecting the world today. Poor health literacy is cited as a major barrier for control of blood pressure and cardiovascular-associated risk factors. Hypertension can be managed via health promotional behaviors such as routine home blood pressure monitoring, adherence to prescribed pharmacological treatment, diet and lifestyle changes. An educational tool catered towards patient health literacy can increase their knowledge and confidence of hypertension disease process and management. Methods: A hypertension patient educational tool was developed for the practice and evaluated via the use of a post-education quantitative survey to assess patient self-management confidence, hypertension knowledge, and ability to identify warning signs of hypertensive crisis. Participants are also asked of their likelihood to recommend the educational tool to friends and family and are encouraged to provide additional feedback at the end of the survey. Results: Twenty-four participants were involved in the study, whom all completed it its entirely. The study found a 22% increase (from 3.54 to 4.63) in mean reported blood pressure (BP) knowledge, with 100% accuracy on the knowledge-based question on normal BP. Ability to identify warning signs and understand the importance of BP management also showed promising results post-education, with a mean of 4.50 and 4.71, respectively, out of a possible 5. 9 Confidence in managing BP was found to be 4.38 post-education. The likelihood of recommending the education was at 4.54. Received overall positive verbal and written feedback from participants upon completion. Conclusion: The study findings corroborated the aim of this quality improvement project in improving patient knowledge and confidence in hypertension management. The educational tool received overwhelmingly positive feedback from participants and practice staff. The clinic should consider integrating the education into electronic delivery methods and development of educational tools in other areas of patient knowledge deficit.