DNP Alumni Yamane and De Gagne Publish Article in Nursing Forum

Sandra Yamane, DNP'19, and Jennie De Gagne, professor; published an article entitled "Assessment of a Patient-Centered Initiative to Improve Hypertension Management for Adults with Comorbid Type 2 Diabetes at a Free Clinic in the Rural South" in Nursing Forum. Co-authors include Alysse Riggs, Davie County Health Department; and George Kimberly and Martha Holye, Storehouse for Jesus.

Abstract

Background:Hypertension is the most modifiable risk factor for cardiovasculardisease. Low levels of adherence to medication regimens, positive health behaviors,and ideal metric goals are associated with low rates of morbidity and mortality,impaired physical function, and frailty.Aim:This quality improvement study sought to assess whether a program of patientand provider education, combined with a decision aid (DA) designed to increaseshared decision making, would improve (a) patient knowledge about hypertensionmanagement, (b) provider adherence to prescription guidelines for the managementof hypertension, (c) medication adherence for the management of hypertension bythe patient, and (d) communication between provider and patient.Setting:Free clinic in the United States rural south.Participants:Twenty‐four patients with comorbid hypertension and type 2 diabetes.Methods:A pretest/posttest design utilizing a provider education, pre‐encounterquiz, focused patient education, and DA was used to evaluate the intervention.Results:A significant increase in pretest/posttest scores 60% (SD = 29%) to 93%(SD = 15%),P< .001 about hypertension and its management was observed.Adherence to guideline‐based medication use increased angiotensin‐convertingenzyme inhibitors 38% to 64%, angiotensin II receptor blockers 17% to 29%,dihydropyridine calcium channel blockers 29% to 43%, beta‐blockers 8% to 25%,statins 65% to 83%, and diuretics 38% to 46%.Conclusions:The intervention was an efficient method to provide patient‐centerededucation that increased patient knowledge about medication and lifestyle manage-ment of hypertension.