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https://hdl.handle.net/2440/92703
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Type: | Journal article |
Title: | Impact of nurse-mediated management on achieving blood pressure goal levels in primary care: insights from the Valsartan Intensified Primary carE Reduction of Blood Pressure Study |
Author: | Carrington, M.J. Jennings, G.L. Harris, M. Nelson, M. Schlaich, M. Stocks, N.P. Burrell, L.M. Amerena, J. de Looze, F.J. Swemmer, C.H. Kurstjens, N.P. Stewart, S. |
Citation: | European Journal of Cardiovascular Nursing, 2016; 15(6):409-416 |
Publisher: | SAGE Publications |
Issue Date: | 2016 |
ISSN: | 1474-5151 1873-1953 |
Statement of Responsibility: | Melinda J Carrington, Garry L Jennings, Mark Harris, Mark Nelson, Markus Schlaich, Nigel P Stocks, Louise M Burrell, John Amerena, Ferdinandus J de Looze, Carla H Swemmer, Nicol P Kurstjens and Simon Stewart, on behalf of the VIPER-BP Study investigators |
Abstract: | BACKGROUND: Blood pressure targets in individuals treated for hypertension in primary care remain difficult to attain. AIMS: To assess the role of practice nurses in facilitating intensive and structured management to achieve ideal BP levels. METHODS: We analysed outcome data from the Valsartan Intensified Primary carE Reduction of Blood Pressure Study. Patients were randomly allocated (2:1) to the study intervention or usual care. Within both groups, a practice nurse mediated the management of blood pressure for 439 patients with endpoint blood pressure data (n=1492). Patient management was categorised as: standard usual care (n=348, 23.3%); practice nurse-mediated usual care (n=156, 10.5%); standard intervention (n=705, 47.3%) and practice nurse-mediated intervention (n=283, 19.0%). Blood pressure goal attainment at 26-week follow-up was then compared. RESULTS: Mean age was 59.3±12.0 years and 62% were men. Baseline blood pressure was similar in practice nurse-mediated (usual care or intervention) and standard care management patients (150 ± 16/88 ± 11 vs. 150 ± 17/89 ± 11 mmHg, respectively). Practice nurse-mediated patients had a stricter blood pressure goal of ⩽125/75 mmHg (33.7% vs. 27.3%, p=0.026). Practice nurse-mediated intervention patients achieved the greatest blood pressure falls and the highest level of blood pressure goal attainment (39.2%) compared with standard intervention (35.0%), practice nurse-mediated usual care (32.1%) and standard usual care (25.3%; p<0.001). Practice nurse-mediated intervention patients were almost two-fold more likely to achieve their blood pressure goal compared with standard usual care patients (adjusted odds ratio 1.92, 95% confidence interval 1.32 to 2.78; p=0.001). CONCLUSION: There is greater potential to achieve blood pressure targets in primary care with practice nurse-mediated hypertension management. |
Keywords: | Nurse management; blood pressure; hypertension; primary care |
Rights: | © The European Society of Cardiology 2015 |
DOI: | 10.1177/1474515115591901 |
Published version: | http://dx.doi.org/10.1177/1474515115591901 |
Appears in Collections: | Aurora harvest 2 General Practice publications |
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