Nurse management for hypertensionA systems approach

Rudd, Peter; Houston-Miller, Nancy; Kaufman, J. H.; KRAEMER, H; Bandura, Albert; Greenwald, George; DeBusk, Robert F.

doi:10.1016/s0895-7061(04)00867-2

Cited by 107 publications

(113 citation statements)

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“…Nine of the 11 trials reviewed were complex interventions that tested the effects of HBPM in combination with other adherence-enhancing strategies such as patient education, 118,119 counseling on medication adherence by nurses, pharmacists, or through a telephone-linked system, 120 -122 use of timed-medication reminders, 123 monthly home visits, 124 and nurse case management. 125 Fifty-four percent of the trials (6 of 11) reported statistically significant improvement in medication adherence attributed to HBPM, and the intervention effects were greatest in trials that tested HBPM along with other adherence-enhancing strategies.…”

Section: Effects On Medication Adherencementioning

confidence: 99%

“…However, when the intervention effects were categorized on the basis of the type of medication adherence measure employed in each of the individual trials, all 3 studies that employed objective electronic monitoring of medication adherence reported positive intervention effects, 123,125,126 and 3 of 5 trials that utilized pill counts reported significant improvement in medication adherence, 120,122,127 whereas all the studies that utilized self-report measures or pharmacy refill data reported negative find-ings. 118,119,121,124,128 The authors concluded that the data on the effects of HBPM on patients' medication-taking behavior are mixed and that HBPM should be considered a useful adherence-enhancing strategy, especially when used in combination with other approaches such as patient counseling, patient reminders, and use of nurse case managers.…”

Section: Effects On Medication Adherencementioning

confidence: 99%

“…162 Several studies have demonstrated that effective control of hypertension can be achieved when patients using HBPM can communicate with their providers (either trained nurse clinicians or physicians) to adjust medication as needed to achieve goals for treatment. 125,[163][164][165] The significance of apparent control of hypertension with the use of HBPM with regard to prevention of cardiovascular morbidity and mortality is not established. In the aforementioned study, which compared HBPM with office management for hypertension and used the same BP goal for both office and home assessment, 113 the cost of treatment (medication) was slightly lower for the HBPM group because less medication was required for control, but the target level of BP (a diastolic pressure of 80 to 89 mm Hg) was higher than generally recommended.…”

Section: Costs and Savings Related To Implementation And Use Of Hbpmmentioning

confidence: 99%

See 2 more Smart Citations

Call to Action on Use and Reimbursement for Home Blood Pressure Monitoring

Pickering¹,

Miller

Ogedegbe³

et al. 2008

Hypertension

485

235

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Abstract-Home blood pressure monitoring (HBPM) overcomes many of the limitations of traditional office blood pressure (BP) measurement and is both cheaper and easier to perform than ambulatory BP monitoring. Monitors that use the oscillometric method are currently available that are accurate, reliable, easy to use, and relatively inexpensive. An increasing number of patients are using them regularly to check their BP at home, but although this has been endorsed by national and international guidelines, detailed recommendations for their use have been lacking. There is a rapidly growing literature showing that measurements taken by patients at home are often lower than readings taken in the office and closer to the average BP recorded by 24-hour ambulatory monitors, which is the BP that best predicts cardiovascular risk. Because of the larger numbers of readings that can be taken by HBPM than in the office and the elimination of the white-coat effect (the increase of BP during an office visit), home readings are more reproducible than office readings and show better correlations with measures of target organ damage. In addition, prospective studies that have used multiple home readings to express the true BP have found that home BP predicts risk better than office BP (Class IIa; Level of Evidence A). This call-to-action article makes the following recommendations: (1) It is recommended that HBPM should become a routine component of BP measurement in the majority of patients with known or suspected hypertension; (2) Patients should be advised to purchase oscillometric monitors that measure BP on the upper arm with an appropriate cuff size and that have been shown to be accurate according to standard international protocols. They should be shown how to use them by their healthcare providers; (3) Two to 3 readings should be taken while the subject is resting in the seated position, both in the morning and at night, over a period of 1 week. A total of Ն12 readings are recommended for making clinical decisions; (4) HBPM is indicated in patients with newly diagnosed or suspected hypertension, in whom it may distinguish between white-coat and sustained hypertension. If the results are equivocal, ambulatory BP monitoring may help to establish the diagnosis; (5) In patients with prehypertension, HBPM may be useful for detecting masked hypertension; (6) HBPM is recommended for evaluating the response to any type of antihypertensive treatment and may improve adherence; (7) The target HBPM goal for treatment is Ͻ135/85 mm Hg or Ͻ130/80 mm Hg in high-risk patients; (8) HBPM is useful in the elderly, in whom both BP variability and the white-coat effect are increased; (9) HBPM is of value in patients with diabetes, in whom tight BP control is of paramount importance; (10) Other populations in whom HBPM may be beneficial include pregnant women, children, and patients with kidney disease; and (11) HBPM has the potential to improve the quality of care while reducing costs and should be reimbursed. (Hypertension. 2008;52:10-29.)

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Section: Effects On Medication Adherencementioning

confidence: 99%

Section: Effects On Medication Adherencementioning

confidence: 99%

Section: Costs and Savings Related To Implementation And Use Of Hbpmmentioning

confidence: 99%

See 1 more Smart Citation

Call to Action on Use and Reimbursement for Home Blood Pressure Monitoring

Pickering¹,

Miller

Ogedegbe³

et al. 2008

Hypertension

485

235

View full text Add to dashboard Cite

show abstract

“…57,58,60 3) HOME BP AND TELEMEDICINE With the advance of devices for home BP measurements, BP values have begun to be stored as electronic data. As a result, such data have been transmitted via telephone lines or the internet, and are widely used for decision making [61][62][63][64][65] and clinical pharmacological evaluations. 65,66 Improvements in BP control by means of such telemedicine have been reported.…”

Section: ) Home Bp and Prognosismentioning

confidence: 99%

The Japanese Society of Hypertension Guidelines for Self-monitoring of Blood Pressure at Home (Second Edition)

et al. 2012

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INTRODUCTIONSince Riva-Rocci invented indirect brachial cuff sphygmomanometry in 1896 1 and Korotkoff proposed the auscultatory method in 1905, 2 the method for blood pressure (BP) measurements has remained essentially unchanged for the past 100 years.In 1969, Posey et al. 3 identified mean BP on the basis of the cuff-oscillometric method. With subsequent theoretical and technical improvements, the method to determine systolic and diastolic BP (S and D, respectively) was introduced to the cuff-oscillometric method. As a result, many of the automatic electronic sphygmomanometers available today have adopted this method, and those different from the auscultatory method have begun to be used in general clinical practice. Since the advent of indirect methods for sphygmomanometry, the past century has developed the practical and clinical sciences of hypertension. However, BP information necessary for the diagnosis and treatment of hypertension is still obtained essentially on the basis of casual measurements at the outpatient clinic (clinic BP). However, the reliability of clinic BP was called into question 40 years after the advent of indirect sphygmomanometry. In 1940, Ayman and Goldshine 4 widely adopted the concept of self-BP measurements in the field of clinic BP measurements and demonstrated discrepancies between clinic BP and self-BP measurements. Bevan, 5 in the United Kingdom, first reported the results of ambulatory BP (ABP) monitoring (ABPM) using a direct arterial BP measurement method in 1969, and showed that human BP changes markedly with time. The quantity and quality of BP information vary greatly according to different methods, and the problem of interpreting clinic BP, which is obtained specifically in a medical environment, has been an issue in the clinical practice of hypertension during the past 50 years.However, the practice and epidemiology of hypertension still depend entirely on BP information obtained in a medical environment (clinic BP/BP at a health examination), resulting in the

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“…Within this approach, professionals such as pharmacists, registered dietitians (RDs), and registered nurses (RNs) can follow an approved treatment algorithm to make basic preventive medication changes for patients without direct consultation with a PCP. [11][12][13][14][15][16][17][18] Published research has focused primarily on using this approach with patients with established disease. The Diabetes Prevention Program, the most successful and arguably well-known of the primary prevention programs, compared outcomes of participants using only a diabetes medication to those of participants who engaged in behavioral strategies, although a combination approach was not studied.…”

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confidence: 99%

HeartBeat Connections: A Rural Community of Solution for Cardiovascular Health

Benson

Sidebottom

VanWormer

et al. 2013

The Journal of the American Board of Family Medicine

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Background: Cardiovascular disease (CVD) continues to be the leading cause of death among Americans. National guidelines emphasize early identification and control of CVD risk factors, but challenges remain in the primary care setting in terms of engaging patients and improving medical therapy adherence. The rapid growth of electronic health records (EHRs) provides a new way to proactively identify populations of high-risk patients and target them with prevention strategies. The HeartBeat Connections (HBC) program was developed as part of a population-based demonstration project aimed at reducing myocardial infarctions.Methods: HBC uses EHR data to identify residents at high CVD risk in a rural community. Participants receive coaching from a registered dietitian or a registered nurse focused on lifestyle behavior changes and preventive medication initiation/titration.Discussion: HBC provides patients with access to nonprescribing professionals on a more frequent basis than typical office visits, and it is focused specifically on helping patients improve lifestyle behaviors and medication adherence as they relate to the primary prevention of CVD.Conclusion 1,2 A national study found that the prevalence of coronary heart disease was 39% higher among people living in rural areas than among their urban counterparts. These disparities are a function of many social, environmental, and cultural factors but seem to culminate in the underutilization of primary and preventive care. 3 The prevalence of CVD remains higher for rural residents even after adjusting for CVD risk factors such as poverty, obesity, and tobacco use. National guidelines 5,6 emphasize early identification and control of CVD risk factors as key to CVD prevention, but many challenges exist in the primary care setting in terms of engaging patients and improving adherence to medical therapies. A recent study examining the knowledge and attitudes of primary care providers (PCPs) in the management of CVD risk found that major gaps remain in PCPs' adherence to recommended preventive care guidelines. The competing demands that physicians face during medical encounters present the principal barrier to the provision of specific CVD services to patients. These demands include paThis article was externally peer reviewed.

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Nurse management for hypertensionA systems approach

Cited by 107 publications

References 0 publications

Call to Action on Use and Reimbursement for Home Blood Pressure Monitoring

Call to Action on Use and Reimbursement for Home Blood Pressure Monitoring

The Japanese Society of Hypertension Guidelines for Self-monitoring of Blood Pressure at Home (Second Edition)

HeartBeat Connections: A Rural Community of Solution for Cardiovascular Health

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