Nurse-led Disease Management for Hypertension Control in a Diverse Urban Community: a Randomized Trial

Hebert, Paul L.; Sisk, Jane E.; Tuzzio, Leah; Casabianca, Jodi M.; Pogue, Velvie A.; Wang, Jason; Chen, Ying‐Chun; Cowles, Christine B; McLaughlin, Mary Ann

doi:10.1007/s11606-011-1924-1

Cited by 53 publications

(102 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Likewise, nurse-led team-based care usually includes health coaching and/or home BP monitoring (35,36). Community health worker-led team-based strategies typically include health coaching, home BP monitoring, and provider training (37).…”

Section: Discussionmentioning

confidence: 99%

Comparative Effectiveness of Implementation Strategies for Blood Pressure Control in Hypertensive Patients

et al. 2017

View full text Add to dashboard Cite

Background The prevalence of hypertension is high and increasing worldwide while the proportion of controlled hypertension is low. Purpose To assess the comparative effectiveness of 8 implementation strategies for blood pressure (BP) control in adults with hypertension. Data Sources Systematic searches of MEDLINE and Embase from inception to September 2017 with no language restriction supplemented with manual reference searches. Study Selection Randomized controlled trials lasting at least 6 months comparing implementation strategies versus usual care on BP reduction in adults with hypertension. Data Extraction Two investigators independently extracted trial data. Trials were grouped by implementation strategy, and BP reduction effects were compared using multivariate-adjusted generalized estimating equations. A modified Cochrane Risk of Bias tool was used for trial quality assessment. Data Synthesis A total of 121 comparisons from 100 articles with 55,920 hypertensive patients were included. Multilevel, multicomponent strategies, such as team-based care with medication titration by non-physician [−7.1 mmHg (95% CI: −8.9, −5.2)], team-based care with medication titration by physician [−6.2 mmHg (−8.1, −4.2)], and multilevel strategies without team-based care [−5.0 mmHg (−8.0, −2.0)] were most effective for systolic BP reduction. Patient-level strategies also resulted in significant systolic BP reductions of −3.9 mmHg (−5.4, −2.3) for health coaching and −2.7 mmHg (−3.6, −1.7) for home BP monitoring. Similar trends were observed for diastolic BP reduction. Provider training was tested in few trials and resulted in non-significant BP reduction. Limitations Sparse data from low- and middle-income countries, few trials of some implementation strategies, and possible publication bias. Conclusions Multilevel, multicomponent strategies, followed by patient-level strategies, are most effective for BP control in patients with hypertension and ought to be used to improve hypertension control. Primary Funding Source US National Institutes of Health

show abstract

Section: Discussionmentioning

confidence: 99%

Comparative Effectiveness of Implementation Strategies for Blood Pressure Control in Hypertensive Patients

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Considering that CPAP therapy was shown to be effective in preventing the transitory increase in BP in patients with OSAHS (Stergiou et al, 2013), nurses should take necessary measures such as stage-matched intervention to improve CPAP adherence (Deng, Wang, Sun, & Chen, 2013). To improve self-care behaviors, we suggest that nurses provide face-to-face counseling and regular telephone follow-up with the patients to stress the importance of vigilance in BP monitoring using a home BP monitor and BP diaries, suggest strategies to improve medication adherence, provide instructions to patients on how to read food labels on foods to better monitor salt and fat intake, and conduct health education on reducing smoking and alcohol consumption (Hebert et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

The Prevalence and Clinical Features of Hypertension in Patients With Obstructive Sleep Apnea Hypopnea Syndrome and Related Nursing Strategies

Wang

Yang

Feng

et al. 2016

Journal of Nursing Research

View full text Add to dashboard Cite

show abstract

“…31 A nurse led intervention tailored specifically to blacks and Hispanics in Harlem, NY found a significant reduction in systolic BP in comparison to usual care. 32 What makes this study unique is that we 1) studied BP in four different at-risk groups previously identified as contributing to worse BP control and 2) included 32 medical offices stretched across 15 states.…”

Section: Discussionmentioning

confidence: 99%

Physician–Pharmacist Collaborative Management

et al. 2016

View full text Add to dashboard Cite

Physician-pharmacist collaboration improves blood pressure but there is little information on whether this model can reduce the gap in health care disparities. This trial involved 32 medical offices in 15 states. A clinical pharmacist was embedded within each office and made recommendations to physicians and patients in intervention offices. The purpose of the present analysis was to evaluate if the pharmacist intervention could reduce health care disparities by improving blood pressure in high risk racial and socioeconomic subjects compared to the control group. The analyses in minority subjects were pre-specified secondary analyses but all other comparisons were secondary, post-hoc analyses. The 9-month visit was completed by 539 patients, 345 received the intervention and 194 were in the control group. Following the intervention, mean systolic blood pressure was 7.3 mm Hg (95%CI= 2.4, 12.3) lower in subjects from racial minority groups who received the intervention compared to the control group (p=0.0042). Subjects with ≤12 years of education in the intervention group had a systolic blood pressure 8.1 mm Hg (95% CI=3.2, 13.1) lower than the control group with lower education (p=0.0001). Similar reductions in blood pressure occurred in patients with low incomes, those receiving Medicaid or those without insurance. This study demonstrated that a pharmacist intervention reduced racial and socioeconomic disparities in the treatment of blood pressure. While disparities in blood pressure were reduced by the intervention, there were still non-significant gaps in mean systolic blood pressure when compared to intervention subjects not at risk.

show abstract

Nurse-led Disease Management for Hypertension Control in a Diverse Urban Community: a Randomized Trial

Cited by 53 publications

References 35 publications

Comparative Effectiveness of Implementation Strategies for Blood Pressure Control in Hypertensive Patients

Comparative Effectiveness of Implementation Strategies for Blood Pressure Control in Hypertensive Patients

The Prevalence and Clinical Features of Hypertension in Patients With Obstructive Sleep Apnea Hypopnea Syndrome and Related Nursing Strategies

Physician–Pharmacist Collaborative Management

Contact Info

Product

Resources

About