Effectiveness of nursing case management versus usual care for blood pressure control in adults with hypertension: a systematic review

Abstract

Objective. To synthesize the best available evidence regarding the effectiveness of nursing case management in primary health care, compared to usual care, in improving blood pressure in adults over 18 years with hypertension.
 Methods. Systematic review that includes studies carried out with adult patients diagnosed with hypertension, with or without other concomitant chronic diseases, followed-up by a case manager nurse, who evaluated the effectiveness of case management in the improvement of blood pressure. A critical evaluation of the studies was made and the results of interest were described using the instruments and tools from the Joanna Briggs Institute. Due to the heterogeneity of the included studies, the results of similar measures were not grouped in statistical meta-analysis. A narrative and tabular format was used to synthesize and present them.
 Results. Six randomized controlled trials were critically evaluated and included in the review. The total sample was 1963 participants. The results showed the outcomes compared at baseline and at the end of follow-up (six or twelve months). Regarding the main outcome, systolic and diastolic blood pressure, there was some reduction in the group followed-up through case management in studies lasting six months; however, the impossibility of comparing the findings poses limitations to answering the questions in this review.
 Conclusions. Despite the heterogeneity of the studies, the narrative and tabular analysis demonstrated that short-term case management in primary care (six-month studies) helped to reduce blood pressure levels, although the level of evidence for these results is low or very low.

Mean blood pressure according to the hypertension care cascade: Analysis of six national health surveys in Peru

“…This finding points out that effective treatment coverage needs to be expanded. Health professionals with adequate training [ 9 , 10 ], and also lay personnel (e.g., community health workers) [11] , [12] , [13] , could unload the burden on doctors and even have a better outreach in the community securing that treatment reaches all patients. Health authorities should also improve structural barriers.…”

“…In any case, providing effective treatment should be a priority for general physicians, family doctors and cardiologists, along with authorities at local organizations (e.g., Regional Directorates of Health, Ministry of Health, among others). Collective work with national and local authorities, as well as practitioners and other healthcare professionals [ 9 , 10 ], is warranted to find the best solutions. Patients should also be involved to incorporate their needs and concerns [23] .…”

Design and development of a nurse-led program for the management of bariatric surgery patients - The NURLIFE program

“…The gure of a nurse case manager has proven its bene t in managing several health/disease conditions, especially chronic diseases and self-management of treatment, reducing the number of related hospitalizations, complications, and emergent admissions while promoting quality of life. Chronic diseases such as diabetes and hypertension are conditions that may include more bene ts with followup by a case manager [18], namely in reducing risk behaviors related to these diseases, such as lifestyle change, smoking cessation, better dietary choices, and physical exercise [19]. The joint teamwork between nurses and patients may achieve better results.…”

Nurse‐led intervention for the management of bariatric surgery patients: A systematic review

“…The World Health Organization (WHO) classifies obesity according to the body mass index (BMI), calculated by the height and weight of patients. 1,2 Using this classification, the severity of obesity is divided as Grade I (30-34.9 kg/m 2 ), Grade II (35)(36)(37)(38)(39).9 kg/m 2 ), and Grade III or severe obesity (>40 kg/m 2 ). 3,4 Severe obesity, already categorized as a chronic disease, is considered one of the main risk factors for metabolic syndrome and other chronic diseases such as diabetes, cardiovascular diseases, and some types of cancers.…”

“…The role of specialized nurses first appeared in the United States, initially in cases of mental illnesses, 35 but expanded in geographical terms and in terms of health conditions to primary health care 36 . Evidence of case managers' impact exists for the management of chronic disease patients, 37 providing cost reductions and improvement in the quality of care 38 . Specifically, the figure of nurse case manager has proven its benefit in the management of health conditions, self‐management of treatment, reduction of the number of hospitalizations, and improvement of the quality of life 39–41 .…”