Effectiveness of a Nurse-Led Telehealth Intervention on Self-Care Practices and Healthcare Utilization among Adults with Hypertension in Rural Nagaland: A Quasi-Experimental Study

Abstract

ABSTRACT Hypertension is a major modifiable risk factor for cardiovascular and renal disease, while sustained control depends on medication adherence, healthy behaviours, monitoring and timely follow-up. Rural communities in Nagaland face geographic and service-access constraints that can disrupt continuity of chronic disease care. This quasi-experimental study evaluates a 12-week nurse led telehealth intervention for adults with hypertension in rural Nagaland. The intervention combines scheduled telephone/video contacts, home blood pressure review, self-care counselling, adherence reinforcement and referral coordination. An illustrative dataset of 120 participants was constructed to demonstrate the analytical framework, with 60 participants in each group. The intervention group showed a larger improvement in self-care score (+9.6 vs +3.8 points), systolic blood pressure (-14.9 vs -4.6 mmHg), diastolic blood pressure (-8.1 vs -2.2 mmHg), and hypertension-related healthcare utilization (-0.8 vs -0.2 contacts) than usual care. Because these numerical findings are simulated, they are not evidence of clinical effectiveness. The framework demonstrates how low-bandwidth nurse-led telehealth can be evaluated in rural settings. Prospective cluster-randomized research with longer follow-up, objective utilization data and economic evaluation is recommended.

KEYWORDS: Hypertension, Telehealth, Nurse-led care, Self-care practices, Healthcare utilization, Rural health, Nagaland, Quasi-experimental study