The Effect of a Comprehensive Provider and Patient Intervention to Improve Blood Pressure Control

Purpose: To examine the comprehensive provider and patient intervention (CPPI) compared to usual care (UC) on blood pressure control among newly diagnosed hypertensive patients treated in a nurse practitioner practice. Data Sources: CPPI included provider and patient education, electronic health record messages about the guidelines of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, Treatment of High Blood Pressure (JNC-7), and patient counseling. Blood pressure control (intervention group; CPPI) was assessed and compared to levels of newly diagnosed patients prior to the intervention (usual care group; UC). One-way analysis of variance (ANOVA) tested for between-group differences and independent samples t test tested for within-group differences in blood pressure readings measured at initial visit and 12-week follow-up visit. Conclusions: There were no significant differences between the groups for mean blood pressure on Weeks 1 and 12. Patients in CPPI showed slightly greater improvement in blood pressure classification compared to UC. Follow-up phone calls allowed for identification of barriers for adherence with follow-up appointments. Implications for Practice: JNC-7 provides an evidence-based approach to diagnosis and management of hypertension. Understanding patient barriers to adherence with treatment may lead to more effective programs that address individual patient needs.