Impact of nurse-mediated management on achieving blood pressure goal levels in primary care: Insights from the Valsartan Intensified Primary carE Reduction of Blood Pressure Study

Citation data:

European Journal of Cardiovascular Nursing, ISSN: 1474-5151, Vol: 15, Issue: 6, Page: 409-416

Publication Year:
2016
Usage 202
Abstract Views 155
Link-outs 46
Downloads 1
Captures 36
Exports-Saves 22
Readers 14
Citations 2
Citation Indexes 2
Repository URL:
https://research-repository.uwa.edu.au/en/publications/a140dbc5-902d-472c-9a14-ba16daddf50d; https://researchbank.acu.edu.au/fhs_pub/5702
PMID:
26088568
DOI:
10.1177/1474515115591901
Author(s):
Melinda J Carrington; Garry L Jennings; Mark Harris; Mark Nelson; Markus Schlaich; Nigel P Stocks; Louise M Burrell; John Amerena; Ferdinandus J de Looze; Carla H Swemmer; Nicol P Kurstjens; Simon Stewart; on behalf of the VIPER-BP Study investigators Show More Hide
Publisher(s):
SAGE Publications; Sage Publications Ltd.
Tags:
Medicine; Nursing; nurse management; blood pressure; hypertension; primary care; Cardiology
article description
© European Society of Cardiology.Background: Blood pressure targets in individuals treated for hypertension in primary care remain difficult to attain. Aims: To assess the role of practice nurses in facilitating intensive and structured management to achieve ideal BP levels. Methods: We analysed outcome data from the Valsartan Intensified Primary carE Reduction of Blood Pressure Study. Patients were randomly allocated (2:1) to the study intervention or usual care. Within both groups, a practice nurse mediated the management of blood pressure for 439 patients with endpoint blood pressure data (n=1492). Patient management was categorised as: standard usual care (n=348, 23.3%); practice nurse-mediated usual care (n=156, 10.5%); standard intervention (n=705, 47.3%) and practice nurse-mediated intervention (n=283, 19.0%). Blood pressure goal attainment at 26-week follow-up was then compared. Results: Mean age was 59.3±12.0 years and 62% were men. Baseline blood pressure was similar in practice nurse-mediated (usual care or intervention) and standard care management patients (150 ± 16/88 ± 11 vs. 150 ± 17/89 ± 11 mmHg, respectively). Practice nurse-mediated patients had a stricter blood pressure goal of =125/75 mmHg (33.7% vs. 27.3%, p=0.026). Practice nurse-mediated intervention patients achieved the greatest blood pressure falls and the highest level of blood pressure goal attainment (39.2%) compared with standard intervention (35.0%), practice nurse-mediated usual care (32.1%) and standard usual care (25.3%; p