Related Experiment Videos

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

Knut Schroeder1, Tom Fahey, Sandra Hollinghurst

  • 1Primary Health Care, Department of Community Based Medicine, University of Bristol, UK. k.schroeder@bristol.ac.uk

Family Practice
|January 19, 2005
PubMed

Insights

Nurse-led support did not improve medication adherence or blood pressure control in patients with hypertension. This intervention was also more costly than usual care, offering no clear benefit for managing high blood pressure.

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.
Abstract

Related Concept Videos

Hypertension V: Nursing Management01:23

Hypertension V: Nursing Management

The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
Hypertension IV: Drug Therapy and Lifestyle Modifications01:28

Hypertension IV: Drug Therapy and Lifestyle Modifications

Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
Atherosclerosis IV: Nursing Management01:23

Atherosclerosis IV: Nursing Management

Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
Pre-Procedural Guidelines for Assessing Blood Pressure01:10

Pre-Procedural Guidelines for Assessing Blood Pressure

Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the patient.
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...