Synthesis table from Nurse-led care interventions for high blood pressure control

Synthesis Table from Nurse-Led Care Interventions for High Blood Pressure Control
Katende, Becker
Study 1 Study 2 Study 3 Study 4
Article Authors
Bosworth, (2001) Baig, (2010) Pezzin, (2010) Hebert, (2011)
Participants Participants were drawn from a list of patients who were diagnosed with hypertension and were using blood pressure lowering medicines at the time of the study (Katende & Becker, 2016) A sample size of 100 adults was selected. Participants were chosen from a group of patients that were admitted with uncontrolled hypertension stage 1 and 2
-There was a total of 845 participants
-Sample of 416 African American or Hispanics patients who had a history of uncontrolled hypertension was used.
-Patients with blood pressure greater than or equal to 150/95 mm Hg were only selected.
-Some of the patients had BP greater or equal to 140/85 mm Hg and had diabetes and other renal diseases (Katende & Becker, 2016).
Interventions -All were administered behavioral management interventions by the nurse (Katende & Becker, 2016).
– Medication management and behavioral management interventions were administered as well.
-Usual care was also used whereby participants were selected for primary care.
-Nurse administered and physician administered interventions were used -After randomization, participants are referred to faith community nurse
– Others are assigned to telephone assisted physicians after the randomization process. -They were placed in three-arm community cluster: usual care, basic intervention, and augmented intervention.

-Usual care
Home monitoring alone
Home BP monitor and in-person counseling session and a 9-month follow-up, through telephone (Katende & Becker, 2016).
Outcomes/ Trends in Evidence Levels 2197101111250
-By 18 months of the study, SBP for medication and combined intervention were observed to be better than the usual care (Katende & Becker, 2016).
-Majority of participants enrolled had the adequate blood pressure control maintained at baseline which continued to retain in control for over 18 months.
-Diastolic blood pressure substantially decreased in the medication management arm by over 95 percent.
– Nurses spent about 13.2 minutes on each completed encounter. 2774951111250
-Patients put under faith community nurse referral program recorded a substantial drop 7 to 15 in SBP against 14 to 15 mm Hg.
-Phone-assisted physician appointment substantially dropped
-27 percent of patients in faith community nurse program had medication intensification with regards to the 32 percent in the telephone-assisted program (Katende & Becker, 2016).
-Between both programs, there was no notable deference between hypertension self-care and hypertension knowledge.
-Patients in faith community referral are likely to report both physical and dietary activity counseling (Katende & Becker, 2016). 1162051111250
-One out of five patients successfully achieved blood pressure control after 3 months with no notable difference across all the arms.
-The augmented group had notable relative improvements in the second stage of hypertension at baseline compared to the usual care. Statistically, the variation was 16 percent against 10 percent respectively (Katende & Becker, 2016).
-In this stage, SBP was substantially lower at 3 months for the augmented arm contrary to the usual care.
-The basic intervention stage produced no significant blood pressure improvements
-The augmented intervention successfully increased blood pressure control by over 8.7 percent which is relative to the use care. Statistically, it presents an 8.9 percent against 17.6 percent (Katende & Becker, 2016).
-The augmented intervention gave rise to over 8.3mm Hg relative reduction in blood pressure.
-It also yielded an increase in the percentage by realizing a 20mm Hg reduction in SBP by over 16.4 percent (Katende & Becker, 2016). 311151111250
-There were substantial changes in systolic blood pressure from baseline at 9 months relative usual care in nurse management together with home blood pressure monitor arm.
-Higher BP achieved in the home blood pressure monitor
-After 18 months, there is no major difference in the treatment arms (Katende & Becker, 2016).
-Changes in the prescription practice failed to explain the decrease in BP especially in nurse management.
-There were significant changes in systolic and diastolic blood pressure at 9 and 18 months (Katende & Becker, 2016).

References
Katende, G., & Becker, K. (2016). Nurse-led care interventions for high blood pressure control: Implications for non-communicable disease programs in Uganda. International Journal of Africa Nursing Sciences, 4, 28-41. http://dx.doi.org/10.1016/j.ijans.2016.02.002