Evaluation of a specialist nurse-led hypertension clinic with consultant backup in two inner city general practices: randomized controlled trial.
Fam Pract
; 31(2): 172-9, 2014 Apr.
Article
em En
| MEDLINE
| ID: mdl-24356073
ABSTRACT
BACKGROUND:
Although practice nurses are increasingly involved in hypertension management, there is little robust evidence of effectiveness.OBJECTIVE:
To evaluate the effect of a specialist nurse-led hypertension clinic with consultant backup on change in systolic blood pressure.DESIGN:
Randomized trial.SETTING:
Two inner city general practices. Participants. Three hundred and fifty-three patients, mean age 62 years (range 18-99), with last recorded blood pressure ≥ British Hypertension Society audit standard were randomly allocated to the nurse-led clinic or usual care. Intervention. Patients received a letter informing them that their last blood pressure was over target and inviting them to the clinic. After assessment at the clinic, the nurse discussed any changes in anti-hypertensive treatment with a visiting consultant and the patient's GP, and followed up the patient over 6 months until blood pressure targets were achieved. MAIN OUTCOMEMEASURE:
Reduction in systolic blood pressure, assessed using two audits of the practices' computerized records where blood pressure was measured independently by practice staff before and after the intervention period.RESULTS:
Follow-up was 89% (313/353). There was greater reduction in systolic blood pressure in the clinic group (n = 144) than usual care group (n = 169, adjusted difference 4.4 mmHg; 95% CI 0.7 to 8.2). Of 167 patients randomly selected for the clinic, 91 (55%) attended, 49 had blood pressure above target when measured according to protocol and 26 had their anti-hypertensive treatment intensified by their GP.CONCLUSION:
Invitation to a specialist nurse-led hypertension clinic with consultant back up was associated with reduced systolic blood pressure.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
População Urbana
/
Prática Avançada de Enfermagem
/
Padrões de Prática em Enfermagem
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Medicina Geral
/
Hipertensão
Tipo de estudo:
Clinical_trials
/
Guideline
Limite:
Aged
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article