Effectiveness of Hybrid Nurse-Led Self-Management Education with a Digital Pocketbook on Medication Adherence and Blood Pressure Control among Patients with Hypertension: A Quasi-Experimental Study
DOI:
https://doi.org/10.31674/mjmr.2026.v010i04.03Abstract
Background: Sustained medication adherence and effective self-management are essential for hypertension control. This study examined the association between hybrid nurse-led self-management education incorporating a Digital Pocketbook and medication adherence and blood pressure outcomes among adults with hypertension. Methods: A non-randomized quasi-experimental study with a pretest–posttest control-group design involved 62 adults with hypertension at a primary healthcare facility in Central Java, Indonesia. Participants were allocated to an intervention group (n = 31) or control group (n = 31). The eight-week intervention combined individualized nurse-led education, a Digital Pocketbook, and weekly WhatsApp follow-up, while controls received routine care. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8), and blood pressure was measured using standardized automated procedures. Analysis of covariance (ANCOVA) adjusted for baseline outcome values. Results: Compared with controls, the intervention group demonstrated higher medication adherence (adjusted mean difference = 2.18; 95% CI: 1.56–2.80), lower systolic blood pressure (−17.84 mmHg; 95% CI: −22.77 to −12.91), and lower diastolic blood pressure (−11.05 mmHg; 95% CI: −14.34 to −7.76). All comparisons were statistically significant (p < 0.001), including after Bonferroni correction. Conclusions: Hybrid nurse-led education incorporating a Digital Pocketbook was associated with improved self-reported medication adherence and reduced blood pressure over eight weeks. Larger randomized trials with objective adherence measures and longer follow-up are needed to establish effectiveness and sustainability.
Keywords:
Digital Pocketbook, Hypertension, Medication Adherence, Nurse-Led Education, Self-ManagementDownloads
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