Effect of an intensive nurse-managed medical care programme on ambulatory blood pressure in hypertensive patients

Ulm, Kurt; Huntgeburth, Ulrich; Gnahn, Hans; Briesenick, C.; Pürner, Klaus; Middeke, Martin

doi:10.1016/j.acvd.2010.01.006

Cited by 15 publications

(25 citation statements)

References 29 publications

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“…Larger improvements in this outcome were found for these two groups compared to studies 26,27,39,61,69 where > 50% of patients already had controlled BP at baseline. Similarly, 26 studies 22,24,30– 34,36–38,41,42,44,48,51–55,57,58,62,64,72,73,76 that reported an average SBP ≥ 140 mmHg at baseline had a greater reduction in SBP than those where the average SBP was < 140 mmHg at baseline. This trend was also seen in six studies 41,42,44,52,62,73 that had an average DBP reading ≥ 90 mmHg at baseline (Table 3).…”

Section: Evidence Synthesismentioning

confidence: 95%

“…Thirty-eight studies were conducted in the U.S. 21–31,33,36–45,47–51,55,58,63–65,69,74,76,95–97 and the remaining studies in Europe 34,52,54,56,57,61,73,75 , Canada, 32,53,62,68,72 and Japan. 71 Forty-one studies 21,22,24–27,30,31,33,34,36– 45,47,49–52,54–58,61,63,64,68,69,71–75,95,96 were implemented solely within healthcare settings and nine studies 23,28,29,32,48,53,65,76,97 were implemented in community settings.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…22,24–28,32,34,39,44,47,48,52,58,62,63,65,69,73–75,95 One study examined multiple levels of team member roles using multiple study arms. 27 The first two levels of medication management demonstrated larger improvements in BP outcomes than overall estimates (Table 3).…”

Section: Evidence Synthesismentioning

confidence: 99%

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Team-Based Care and Improved Blood Pressure Control

Proia

Thota

Njie

et al. 2014

American Journal of Preventive Medicine

187

166

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Context Uncontrolled hypertension remains a widely prevalent cardiovascular risk factor in the U.S. team-based care, established by adding new staff or changing the roles of existing staff such as nurses and pharmacists to work with a primary care provider and the patient. Team-based care has the potential to improve the quality of hypertension management. The goal of this Community Guide systematic review was to examine the effectiveness of team-based care in improving blood pressure (BP) outcomes. Evidence acquisition An existing systematic review (search period, January 1980–July 2003) assessing team-based care for BP control was supplemented with a Community Guide update (January 2003–May 2012). For the Community Guide update, two reviewers independently abstracted data and assessed quality of eligible studies. Evidence synthesis Twenty-eight studies in the prior review (1980–2003) and an additional 52 studies from the Community Guide update (2003–2012) qualified for inclusion. Results from both bodies of evidence suggest that team-based care is effective in improving BP outcomes. From the update, the proportion of patients with controlled BP improved (median increase=12 percentage points); systolic BP decreased (median reduction=5.4 mmHg); and diastolic BP also decreased (median reduction=1.8 mmHg). Conclusions Team-based care increased the proportion of people with controlled BP and reduced both systolic and diastolic BP, especially when pharmacists and nurses were part of the team. Findings are applicable to a range of U.S. settings and population groups. Implementation of this multidisciplinary approach will require health system–level organizational changes and could be an important element of the medical home.

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Section: Evidence Synthesismentioning

confidence: 95%

Section: Evidence Synthesismentioning

confidence: 99%

See 1 more Smart Citation

Team-Based Care and Improved Blood Pressure Control

Proia

Thota

Njie

et al. 2014

American Journal of Preventive Medicine

187

166

View full text Add to dashboard Cite

show abstract

“…The 8-week of sustained follow-up randomized controlled trial of comprehensive lifestyle modification revealed that the experimental group achieved a prominent improvement and significant reduction both in systolic (19.03 mmHg) and diastolic blood pressures (11.68 mmHg) (Appel et al, 2003). Based from the intensive nurse-managed care program for hypertension in Germany, this intervention program booklet revealed no statistically significant difference in the pre-and post-systolic (p=.332) blood pressure readings of the control group (Ulm et al, 2010). Moreover, reduction in systolic blood pressure showed no significance in the control group (-2.10±7.10 mmHg; p=0.036) with a reduction in systolic BP from 132.40±13.50 mmHg to 128.20±13.00 mmHg.…”

Section: Discussionmentioning

confidence: 88%

“…Likewise, a study stated that the education program for hypertension in Germany caused a significant improvement in the blood pressure among hypertensive patients as evidenced by a decreased from systolic BP 153.00 mmHg (SD±16.00)/diastolic BP 89.00 mmHg (SD±10.00) before the program to systolic BP 146.00 mmHg (SD±12.00)/diastolic BP 85.00 mmHg (SD±8.00) six months after the said program (Friedrich et al, 2000). Lastly, the intensive nurse-managed care program for hypertension in Germany revealed that the drop in systolic blood pressure was suggestively superior in the experimental group (-7.60±11.70 mmHg; p=0.036) than in the control group (-3.30±11.70 mmHg; p=0.036) after the said intervention program booklet (Ulm et al, 2010).…”

Section: Discussionmentioning

confidence: 96%

The effectiveness of health education and lifestyle program in improving the blood pressure in hypertensive patients

al.¹

2019

Int. j. adv. appl. sci.

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Risk factors for hypertension are becoming increasingly prevalent. Currently, there is no standardized community-based program for hypertension widely implemented in the Philippines. Health Education and Lifestyle Program for Hypertension is a ten-week health education program that aims to improve the blood pressure in hypertensive patients. This community-based intervention discusses five key health strategies like hypertension awareness, medication regimen, dietary regimen, healthy lifestyles, and stress management. This quasi-experimental study includes 128 hypertensive patients (64 in control and 64 in intervention groups). It utilized IBM SPSS 5.0 to statistically compute for mean, standard deviation, ttest independent samples and t-test paired sample. The study findings revealed that the post-systolic and diastolic blood pressure of the intervention group were 124.67 and 82.00 mmHg, respectively. Paired t-test yielded a significant difference in pre-and post-systolic (t=5.28, p=<.001) and pre-and post-diastolic (t=3.59, p=0.003) BP of the intervention group before and after the Health Education and Lifestyle Program. Lastly, t-test for independent samples revealed a statistically significant difference (t=2.32, p=0.028) in the post-diastolic blood pressure readings of control and intervention groups after the implementation of the program. The study implied that program for hypertension was effective in improving blood pressure in hypertensive patients. Thus, compliance with the medication regimen, dietary regimen, healthy lifestyles, and stress reduction strategies can help control blood pressure among hypertensive patients. A health education program that provides emphasis on patient's health and lifestyle behavior teaching is a successful intervention in reducing the blood pressure in hypertensive individuals.

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Nurse Led Interventions in Hypertension

Clark

2018

Drug Adherence in Hypertension and Cardiovascular Protection

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Effect of an intensive nurse-managed medical care programme on ambulatory blood pressure in hypertensive patients

Abstract: An intensive medical care programme in the office setting managed by trained nurses can improve BP control effectively. Nurses could take more responsibility for managing hypertensive patients.

Cited by 15 publications

References 29 publications

Team-Based Care and Improved Blood Pressure Control

Team-Based Care and Improved Blood Pressure Control

The effectiveness of health education and lifestyle program in improving the blood pressure in hypertensive patients

Nurse Led Interventions in Hypertension

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