Patient activation, adherence to hypertension treatment plans and blood pressure control in Saudi Arabia: a cross-sectional study

Abstract

Objectives To explore the relationship between patient activation, adherence to hypertension treatment plans, blood pressure control and other important demographic factors.Design A cross-sectional study.Setting Primary healthcare centres in Riyadh province, Saudi Arabia.Participants A total of 114 adults with hypertension, including 68 men and 46 women.Outcome measurements Blood pressure control is achieved if (a) patients under 80 years of age with treated hypertension have blood pressure under 140/90 mm Hg or (b) patients aged 80 years or over with treated hypertension have blood pressure under 150/90 mm Hg. Secondary outcomes included patient activation, adherence to hypertension treatment plans and demographic factors (age, gender, education, income and comorbidity). Data were analysed using Pearson’s correlation and multiple regression models.Results 57% (n=66) of participants did not achieve the ideal blood pressure target. Perfect adherence to hypertension treatment plans was significantly associated with lower systolic (r=−0.38, p<0.01) and diastolic blood pressure (r=−0.50, p<0.01). Age was significantly correlated with patient activation (r=−0.20, p<0.05) and diastolic blood pressure (r=−0.33, p<0.01). There was no statistically significant association between Patient Activation Measure, systolic blood pressure and diastolic blood pressure. In the hierarchical regression analysis, adherence to hypertension treatment plans was found to be a significant predictor and explained 15% of the variance in systolic blood pressure (β=−0.36, p<0.001) and 26% of the variance in diastolic blood pressure (β=−0.51, p<0.001).Conclusion The individual and family self-management theory can serve as an effective theory for understanding the key factors in achieving ideal blood pressure target. The majority of patients with hypertension reported lower levels of activation and poor blood pressure control. Inadequate adherence to treatment plans was related to poor blood pressure control. This work is pivotal in devising self-management interventions to assist patients in the management of hypertension disease, especially in Saudi Arabia.