Implementing Evidence-Based Education in Primary Care to Combat the Silent Killer

Abstract

Hypertension (HTN), the ‘silent killer’, affects 48.1% of U.S. adults and often remains undiagnosed until complications like cardiovascular disease, kidney failure, and stroke arise. Limited patient education and poor medication adherence contribute to uncontrolled HTN. In a rural primary care office, the lack of standardized education led to inconsistent or minimal HTN education, creating a barrier to effective management. This quality improvement project implemented standardized, evidence-based HTN education intervention in primary care to improve blood pressure control and medication adherence among adults with uncontrolled HTN. The Model for Improvement framework and Knowles’ Adult Learning Theory guided the intervention. A pre/post intervention design was utilized. Eligible patients (n = 21) with blood pressure ≥ 140/90 mmHg received structured HTN education using American Heart Association and UpToDate resources. The Hill-Bone Medication Adherence Scale measured adherence, and an advanced practice provider recorded blood pressure. Wilcoxon signed-rank tests and linear regressions analyzed outcomes. Post intervention, mean systolic blood pressure decreased from 150 to 138 mmHg (p < 0.05), and diastolic from 87 to 82 mmHg (p < 0.05). Medication adherence improved, particularly in reducing forgetfulness (p <0.05). These statistically and clinically significant results demonstrate the impact of standardized HTN education. This project reinforces nursing’s role in quality improvement by promoting evidence-based education, improving adherence, and supporting better blood pressure management, reducing the long-term burden of HTN on patients and the healthcare system.