Impact of home-based follow-up care on hypertension control among patients attending Thika Level Five Hospital, Kiambu County, Kenya: A randomized control study

Abstract

Background Hypertension contributes to a large burden of cardiovascular diseases, with a higher prevalence in low- and middle-income countries. Hypertension management is mainly hospital-based, but it faces low retention rates in facilities, non-adherence and subsequent suboptimal blood pressure (BP) control. This study aimed to implement home-based follow-up care and assess its impact on controlling BP. Methods An open-label randomized controlled study was conducted on 200 participants with uncontrolled BP selected using a systematic random sampling technique and randomly assigned into home-based follow-up care (intervention group) and hospital-based follow-up care (control group). Data were collected using a structured questionnaire containing the 8-item Morisky Medication Adherence Scale and Hypertension Self-Care Activity Level Effect (H-SCALE). Data were analysed using SPSS version 29.0. Results Hypertension control was 52.0% and 92.2% in the control and intervention groups, respectively. In the interventional group, drug adherence increased from 38.2% to 94.1% compared with a reduction in the control group from 45.9% to 33.7%. Dietary Approaches to Stop Hypertension diet adherence rose from 2.9% to 76.5% compared with a control group from 1% to 2%. Conclusions Home-based care follow-up has a significant impact on the control of hypertension.