Abstract Because the elderly are viewed as having more difficulty in complying with therapy, this analysis was directed at the effects of a health education program on their control of primary hypertension when compared with a younger population. The program consisted of three sequential interventions introduced in a randomized factorial design. Despite the fact that elderly patients had more chronic disease, more complications from hypertension, and were receiving more complex drug therapies than younger patients exposed to the same experimental interventions, they demonstrated significantly higher levels of compliance with drug therapy, significantly higher levels of appointment keeping, and no difference in the proportion having their BP under control at two-year follow-up. Longitudinal data collected at five-year follow-up indicate no decay effect. These results indicate such programs can be successfully implemented and equally effective for an elderly population. (Arch Intern Med 1982;142:1835-1838) References 1. Five-year findings of the Hypertension Detection and Follow-up Program: I. Reduction in mortality of persons with high blood pressure, including mild hypertension. Hypertension Detection and Follow-up Program Cooperative Group. JAMA 1979;242:2562-2571.Crossref 2. National Center for Health Statistics: Hypertension in adults 25-74 years of age, United States, 1971-1975. Vital Health Stat  , 1981, No. 221. 3. Veterans Administration Cooperative Study Group on Antihypertensive Agency: Effects of treatment on morbidity in hypertension: Results in patients with diastolic blood pressures averaging 115 through 129 mm Hg. JAMA 1967;202:1028-1034.Crossref 4. Hypertension Detection and Follow-up Program Cooperative Group: Five-year findings on the Hypertension Detection and Follow-up Program: II. Mortality by race, sex, and age. JAMA 1979;242:2572-2577.Crossref 5. Kirkendall WM, Hammon JJ: Hypertension in the elderly. Arch Intern Med 1981;140:1155-1161.Crossref 6. Smith C: Use of drugs in the aged. Johns Hopkins Med J 1979;145:61-64. 7. Vestal RE: Drug use in the elderly: A review of problems and special considerations. Drugs 1978;16:358-382.Crossref 8. Green LW, Levine DM, Deeds SG: Clinical trials of health education for hypertensive outpatients: Design and baseline data. Prev Med 1975;4:417-425.Crossref 9. Green LW, Levine DM, Wolle J, et al: Development of randomized experiments in patient education with urban poor hypertensives. Patient Counselling Health Educ 1979;1:106-111.Crossref 10. Chwalow AJ, Green LW, Levine DM, et al: Clarification and repetition of hypertension regimens as a first stage in patient education to improve compliance . Read before the meeting of the American Public Health Association, Chicago, Nov 19, 1975. 11. Fass MF: The role of health education in hypertension control. J Family Community Health 1981;4:73-84.Crossref 12. Bowler MH, Morisky DE, Deeds SG: Needs assessment strategies in working with compliance issues and blood pressure control. Patient Counselling Health Educ 1980;1:22-27.Crossref 13. Green LW, Lewis FM, Levine DM: Balancing statistical data and clinician judgments in the diagnosis of patient educational needs. J Community Health 1980;6:79-91.Crossref 14. Levine DM, Green LW, Deeds SG, et al: Health education for hypertensive patients. JAMA 1979;241:1700-1793.Crossref 15. Morisky DE, Levine DM, Green LW, et al: The relative impact of health education for low- and high-risk patients with hypertension. Prev Med 1980;9:550-558.Crossref 16. Morisky DE, Levine DM, Green LW, et al: Five-year blood pressure control and mortality following health education for hypertensive patients. Read before the meeting of the American Public Health Association, Los Angeles, Nov 4, 1981. 17. Haynes RB, Taylor DW, Sackett DL, et al: Can simple clinical measurements detect patient noncompliance? Hypertension 1980;2:757-764.Crossref 18. Morisky DE, Levine DM, Green LW, et al: Behavioral diagnosis as a tool for decision making. Prev Med 1980;9:447.Crossref 19. The 1980 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1980; 140:1280-1285.Crossref 20. Morisky DE, Levine DM, Bone LR, et al: The long-term predictability of blood pressure control using a simple self-reported measure. Read before the eighth annual Institute on Educational Diagnosis and Evaluation in Health Promotion and Medical Care, Baltimore, July 20, 1982. 21. Klein LE, Levine DM, German PS: Adverse drug reactions among the elderly: A reassessment. J Am Geriatr Soc 1981;29:525-530. 22. Atchley RC: Common misconceptions about aging health values. Achieving High Level Wellness 1981;5:7-10.
Archives of Internal Medicine – American Medical Association
Published: Oct 1, 1982