Nurse‐Led Interventions for Hypertension: A Scoping Review With Implications for Evidence‐Based Practice

Spies, Lori A.; Bader, Susan Gerding; Opollo, Jackline G.; Gray, Jennifer

doi:10.1111/wvn.12297

Cited by 25 publications

(33 citation statements)

References 23 publications

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“… 18 , 19 Likely a reduction in the economic cost of hypertension treatment for patients at a larger scale by either decreasing the cost of treatment through task-shifting in care management or by different financing mechanisms may be necessary going forward to accomplish its possible widespread benefit. 18 , 20 , 21 …”

Section: Discussionmentioning

confidence: 99%

The outpatient management of hypertension at two Sierra Leonean health centres: A mixed-method investigation of follow-up compliance and patient-reported barriers to care

Herskind

Zelasko

Bacher

et al. 2020

African Journal of Primary Health Care & Family Medicine

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Background Sub-Saharan Africa faces an increasing burden of non-communicable diseases. In particular, hypertension and its therapeutic control present a challenge and opportunity for health practitioners and health systems within the region. Aim This study sought to assess an initiative conducted by two health clinics to begin treatment of hypertension amongst their patient populations by reviewing medication possession rates and documenting patient-reported barriers to care in the provision of chronic hypertension management. Setting Two private, outpatient health clinics in Sierra Leone recently beginning hypertension management initiatives. Methods A retrospective chart review identified 487 records of patients with diagnosed hypertension and assessed for medication adherence through calculation of medication possession ratios from pharmacy refill data. Surveys were conducted on a convenience sample of 68 patients of the hypertension treatment programme to discern patient-reported barriers of care. Results Medication possession rates were found to be less than 40% in 82% (399/487) of patients, between 40% and 79% in 12% (60/487) of patients and 80% or greater in 6% (28/487) of patients. In surveys of individuals being treated by the programme, patients were most likely to cite transportation (81%, 55/68), financial burden (69%, 47/68) and schedule conflicts with work or other prior commitments (25%, 17/68) as barriers to care. Conclusions In this newly instituted outpatient hypertensive management initiative, 82% of patients had medication possession ratios under 40%, which is likely to impact the clinical effectiveness of the initiative. The most frequent patient-reported barriers to care in surveys included transportation, financial burden and schedule conflicts.

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Section: Discussionmentioning

confidence: 99%

The outpatient management of hypertension at two Sierra Leonean health centres: A mixed-method investigation of follow-up compliance and patient-reported barriers to care

Herskind

Zelasko

Bacher

et al. 2020

African Journal of Primary Health Care & Family Medicine

View full text Add to dashboard Cite

show abstract

“…They also provide a dedicated time for disease-specific education. There is now early evidence of MACs increasing adherence and follow-up amongst patients with NCDs in East Africa, suggesting this model as a promising, cost-effective approach for our study setting [21, 22].…”

Section: Discussionmentioning

confidence: 99%

Exploring patient experiences with and attitudes towards hypertension at a private hospital in Uganda: a qualitative study

Lynch

Green

Nanyonga

et al. 2019

Int J Equity Health

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BackgroundHypertension is the leading risk factor for mortality worldwide and is more common in sub-Saharan Africa than any other region. Work to date confirms that a lack of human and material resources for healthcare access contributes to this gap. The ways in which patients’ knowledge and attitudes toward hypertension determine their engagement with and adherence to available care, however, remains unclear.MethodsWe conducted an exploratory, qualitative descriptive study to assess awareness, knowledge, and attitudes towards hypertension and its management at a large private hospital in Kampala. We interviewed 64 participants (29 with hypertension and 34 without, 1 excluded) in English. General thematic analysis using the Integrated Conceptual Health Literacy Model was used to iteratively generate themes and categories.ResultsWe identified three main themes: Timing of Hypertension Diagnosis, Aiming for Health Literacy, and the Influence of Knowledge on Behavior. Most participants with hypertension learned of their condition incidentally, speaking to the lack of awareness of hypertension as an asymptomatic condition. Drove nearly all participants to desire more information. However, many struggled to translate knowledge into self-management behaviors due to incomplete information and conflicting desires of participants regarding lifestyle and treatment.ConclusionsInternal patient factors had a substantial impact on adherence, calling attention to the need for educational interventions. Systemic barriers such as cost still existed even for those with insurance and need to be recognized by treating providers.

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“…2 In response to rising readmission rates at a Hispanicserving transplant center in southern Texas, a team of nurses collaborated to innovate post-liver transplant teaching and discharge preparation. Although nurse-led quality improvement projects are reported in the literature, 3 this study is the first to report an entirely nurse-led interventional study demonstrating an association with decreased hospital readmissions after liver transplantation.…”

Section: Introductionmentioning

confidence: 83%

Relationship of Nurse-Led Education Interventions to Liver Transplant Early Readmission

et al. 2020

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Introduction: Early hospital readmission following liver transplantation is associated with lower survival and worse long-term graft function. Language, cultural practices, and health literacy influence patient understanding of posttransplant care education. Complex medication regimes, changes in metabolism and nutrition absorption, and infection/rejection further complicate the prevention of readmission. Purpose: The purpose of this study was to compare the 30-day readmissions of single-organ liver transplant recipients for 1-year prior and 1-year following the implementation of nurse-led education. The study examined the demographics, clinical characteristics, and 30-day readmissions of 35 liver transplant recipients who participated in the newly designed nurse-led education and 51 liver transplant recipients who experienced the prior post-liver transplant education. Design: A single-center, correlational study with a convenience sample was conducted at a Hispanic-serving South Texas hospital. The new education intervention maintained the standard education and added twice-daily mutual patient-focused goal setting between the nurse and the recipient that aligned with readiness for discharge activities/goals, structured education using abbreviated handouts written at a second-grade level available in both English and Spanish, and the use of repetition through multimodal methods. Results: The odds for 30-day readmissions the year prior to the nurse-led patient education intervention were 2.088 times greater than the year following the implementation. Thirty-day readmissions were reduced by 16.3% from the 2017 cohort to the 2018 cohort. Discussion: Understanding unique risk factors facilitates structured patient education which can be individualized to the patient and caregiver including collaborative nurse–patient goals.

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Nurse‐Led Interventions for Hypertension: A Scoping Review With Implications for Evidence‐Based Practice

Cited by 25 publications

References 23 publications

The outpatient management of hypertension at two Sierra Leonean health centres: A mixed-method investigation of follow-up compliance and patient-reported barriers to care

The outpatient management of hypertension at two Sierra Leonean health centres: A mixed-method investigation of follow-up compliance and patient-reported barriers to care

Exploring patient experiences with and attitudes towards hypertension at a private hospital in Uganda: a qualitative study

Relationship of Nurse-Led Education Interventions to Liver Transplant Early Readmission

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