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Nurse Led Interventions in Hypertension

  • Christopher E. Clark
Chapter
Part of the Updates in Hypertension and Cardiovascular Protection book series (UHCP)

Abstract

Hypertension is predominantly detected and managed in primary or community care settings. Nurses are key members of the multidisciplinary primary care team and are commonly involved in measuring or managing blood pressure. Nurses undertake a range of tasks in hypertension care and many randomised controlled trials of different nurse led interventions have been conducted, providing evidence from different populations. There is good evidence to support better blood pressure outcomes when nurses deliver care face to face, but not remotely. Other important components of these complex interventions appear to be the inclusion of a structured care algorithm, ability to prescribe or alter medications, and maintaining contact at least monthly until blood pressure is controlled to target. There is limited reporting of the costs of interventions and evidence for cost-effectiveness of nurse led care compared to usual care is lacking. There is no clear evidence from longer term follow-up of the effect of nurse led interventions on cardiovascular outcomes. The design of programmes for nurse led care in hypertension should take account of the existing evidence and areas of uncertainty. Nurses generally work within teams and future studies of team approaches to hypertension, either including or led by nurses, are needed. Any future studies of nurse led care should include a robust cost-effectiveness analysis.

Keywords

Hypertension Management of hypertension Allied health professional Randomised controlled trials 

Notes

Acknowledgments

The analyses presented are based on data collected for our Cochrane review: Allied health professional led interventions for improving control of blood pressure in patients with hypertension (A115). The review has been submitted and publication is anticipated during 2018. I thank my co-authors for their contributions to the review: Lyne Cloutier, Shweta Todkar, Judit Konya, Olivia Clark, Sinead McDonagh, Lindsay Smith, Liam Glynn, Rod Taylor and John Campbell. Disclosure: Christopher Clark is supported by a National Institute of Health Research (NIHR) Clinical Lectureship award. The views expressed are those of the author and not necessarily those of the NIHR, the NHS or the Department of Health.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Primary Care Research GroupUniversity of Exeter Medical School, Smeall Building, St Luke’s CampusExeterUK
  2. 2.Institute of Health Services ResearchExeterUK

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