Improving hypertension management through a nurse-led selfmanagement education program: effects on medicationadherence, blood pressure control, and health-related quality oflife

Abstract

Hypertension remains the leading preventable cause of premature death, stroke, and cardiovascular morbidity globally. Despite highly efficacious pharmacotherapies, therapeutic success is deeply constrained by low medication adherence, poor lifestyle self-regulation, and systematic clinical inertia within physician-centric care models. This comprehensive technical review details the operational design, clinical efficacy, and implementation science of Nurse-Led Self-Management Education (NLSME) programs. Grounded in Social Cognitive Theory, the Health Belief Model, and Orem’s Self-Care Deficit theory, NLSME transforms patients from passive recipients of prescriptions into active, skilled self-managers. We systematically analyse clinical trial data demonstrating that structured nurse-led interventions consistently lower systolic blood pressure by 4.5–7.0 mmHg and diastolic blood pressure by 2.5– 4.5 mmHg while dramatically mitigating clinical inertia. Furthermore, this article breaks down the multi-level barriers to adherence (cognitive, psychosocial, socioeconomic, and regimen-related) and provides comprehensive nurse-led intervention protocols. Finally, we explore the quantifiable impacts of NLSME on Health-Related Quality of Life (HRQoL) across physical and mental domains, address workforce and reimbursement barriers, and chart the integration of next-generation digital therapeutics, automated home blood pressure telemonitoring, and algorithmic risk stratification.