Worldwide, hypertension affects approximately 25% of the adult population and diabetes about 8.5%. Lack of adherence to prescribed treatment regimen remains a problem among patients undergoing long-term treatment, showing high non-adherence rates, at estimated range of between 36 and 93%. In our city, patients with hypertension and diabetes in primary care are looked after mainly by doctors with little nursing support; also, there is no published dataset among Colombian populations on the effect of nursing intervention to increase adherence to therapeutic regimen. The aim of this study was to evaluate the efficacy of nursing intervention “Teaching: Individual” compared with usual care, to increase adherence to therapeutic regimen in people with hypertension and/or type-2 diabetes, and to analyze the impact to glycosylated hemoglobin and systolic blood pressure levels. A two-arm, single-blinded, randomized controlled trial, with participants allocated to either intervention group with “Teaching: Individual” provided by two nurses, or control group receiving routine care only. Two Hundred patients attending cardiovascular risk programs of Bucaramanga, Colombia were included. Nursing intervention consisted of six educational sessions about Coping Enhancement; Behavior Modification; Teaching: Disease Process, Prescribed Medication, Prescribed Diet and Prescribed Exercise. The outcomes were Treatment Behavior: Illness or Injury (adherence to treatment), levels of both glycosylated hemoglobin (HbA1c) and systolic blood pressure for 24 h, to be measured at baseline and two follow-up time points. Basic characteristics of the groups were compared through chi-square/Fisher’s exact or Students-T/Mann-Whitney U test. Outcomes were evaluated with repeated data methods and investigated changes in the outcomes over time and to compare these changes among treatment groups, and statistical significance with p-value < 0.05 were considered. The nursing intervention “Teaching: Individual” to increase adherence to therapeutic regimen in people with hypertension and/or type-2 diabetes represents an innovative care approach intended for low-income population. The study will advise district health system policy makers and managers as to the efficacy of implementing this intervention. Should this intervention turn out efficacious, it can potentially achieve wide application in cardiovascular risk programs. ENURSIN was registered in ClinicalTrials.gov ( NCT02758275 ) on April 27, 2016, protocol number 01.

中文翻译：

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“教学：个人”以增加高血压和 2 型糖尿病患者对治疗方案的依从性：对照临床试验 ENURSIN 的方案。

在世界范围内，高血压影响约 25% 的成年人，糖尿病影响约 8.5%。在接受长期治疗的患者中，缺乏对处方治疗方案的依从性仍然是一个问题，显示出高不依从率，估计范围在 36% 至 93% 之间。在我市，初级保健中的高血压和糖尿病患者主要由医生照顾，很少有护理支持；此外，在哥伦比亚人群中没有公布关于护理干预对提高治疗方案依从性的影响的数据集。本研究的目的是评估护理干预“教学：个体”与常规护理相比的效果，以提高高血压和/或 2 型糖尿病患者对治疗方案的依从性，并分析对糖基化血红蛋白和收缩压水平的影响。一项双臂、单盲、随机对照试验，参与者被分配到由两名护士提供“教学：个人”的干预组或仅接受常规护理的对照组。包括参加哥伦比亚布卡拉曼加心血管风险项目的 200 名患者。护理干预包括六个关于增强应对的教育课程；行为矫正；教学：疾病过程、处方药、处方饮食和处方运动。结果是治疗行为：疾病或损伤（对治疗的依从性）、糖基化血红蛋白 (HbA1c) 水平和 24 小时的收缩压，在基线和两个随访时间点进行测量。通过卡方/Fisher 精确检验或Student-T/Mann-Whitney U 检验比较各组的基本特征。使用重复数据方法评估结果，调查结果随时间的变化，并比较治疗组之间的这些变化，并考虑 p 值 < 0.05 的统计学显着性。旨在提高高血压和/或 2 型糖尿病患者对治疗方案的依从性的护理干预“教学：个体”代表了一种针对低收入人群的创新护理方法。该研究将就实施该干预措施的有效性向地区卫生系统决策者和管理者提供建议。如果这种干预有效，它可能会在心血管风险项目中得到广泛应用。