Nurse-led adherence support in hypertension: a randomized controlled trial

Area of Science:

• Cardiovascular Medicine
• Nursing Research
• Health Services Research

Background:

• Poor medication adherence is a significant factor in uncontrolled hypertension, increasing risks of heart attack and stroke.
• Effective strategies are needed to improve adherence and blood pressure management in community settings.

Purpose of the Study:

• To assess the impact of nurse-led adherence support on medication adherence and blood pressure control.
• To compare nurse-led support against usual care for patients with uncontrolled hypertension.

Main Methods:

• A randomized controlled trial involving 245 adults with uncontrolled hypertension (>= 150/90 mmHg) from 21 UK general practices.
• Participants were assigned to either nurse-led adherence support or usual care.
• Primary outcomes included medication adherence ('timing compliance') and blood pressure levels.

Main Results:

• Baseline medication adherence was high in both groups (90.8% intervention vs. 94.5% control).
• No significant difference in medication adherence was observed at follow-up between the nurse-led support and usual care groups.
• No significant differences in systolic or diastolic blood pressure were found between the groups.
• The nurse-led intervention incurred higher projected primary care costs per consultation.

Conclusions:

• Medication adherence rates in this study exceeded previous reports.
• Nurse-led adherence support did not demonstrate a significant effect on medication adherence or blood pressure control compared to usual care.
• The intervention presented a higher cost from a primary care perspective without clear clinical benefits.