Health Coaching to Improve Hypertension Treatment in a Low-Income, Minority Population

PURPOSE: Poor blood pressure control is common in the United States. We conducted a study to determine whether health coaching with home titration of antihypertensive medications can improve blood pressure control compared with health coaching alone in a low-income, predominantly minority population. METHODS: We randomized 237 patients with poorly controlled hypertension at a primary care clinic to receive either home blood pressure monitoring, weekly health coaching, and home titration of blood pressure medications if blood pressures were elevated (n = 129) vs home blood pressure monitoring and health coaching but no home titration (n = 108). The primary outcome was change in systolic blood pressure from baseline to 6 months. RESULTS: Both the home-titration arm and the no-home-titration arm had a reduction in systolic blood pressure, with no significant difference between them. When both arms were combined and analyzed as a before-after study, there was a mean decrease in systolic blood pressure of 21.8 mm Hg (P <.001 as well a decrease in the number of primary care visits from months before study to during period and after more coaching encounters patients had greater their reduction blood pressure. conclusions: pressure control low-income minority population can be improved by teaching monitor at home having nonprofessional health coaches assist particular counseling them on medication adherence. achieved while reducing time spent physicians.>