Impact of nurse-mediated management on achieving blood pressure goal levels in primary care: Insights from the Valsartan Intensified Primary carE Reduction of Blood Pressure Study

Carrington, Melinda; Jennings, Garry; Harris, Mark; Nelson, Mark; Schlaich, Markus P.; Stocks, Nigel; Burrell, Louise M.; Amerena, John; Looze, Ferdinandus J. de; Swemmer, C.; Kurstjens, N.; Stewart, Simon

doi:10.1177/1474515115591901

Cited by 9 publications

(15 citation statements)

References 22 publications

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“…Sample sizes ranged from 51 (Tonstad et al, 2007) to 1492 (Carrington et al, 2016) patients. The specific interventions reported across studies were varied and multifaceted.…”

Section: Resultsmentioning

confidence: 99%

Nurse‐led interventions to manage hypertension in general practice: A systematic review and meta‐analysis

Stephen

Halcomb

Fernandez

et al. 2022

Journal of Advanced Nursing

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To evaluate the impact of general practice nurse-led interventions for blood pressure control and cardiovascular disease risk factor reduction in patients with hypertension. Systematic review and meta-analysis of randomized control trials. CINAHL, Medline and Scopus databases were searched to identify peer-reviewed studies published between 2000 and 2021. A systematic review of randomized control trials was conducted using a structured search strategy. The Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used to appraise study quality. Meta-analysis and narrative synthesis were performed to determine the effectiveness of the included interventions. Eleven trials comprising of 4454 participants were included in the review. Meta-analysis showed significant reductions in both systolic and diastolic blood pressure in trials with 6 months or less follow-up. Improvements were also demonstrated in reducing blood lipids, physical activity, general lifestyle measures and medication adherence. Evidence for dietary improvements and reduction in alcohol and smoking rates was inconclusive. Nurse-led interventions for patients with hypertension are heterogeneous in terms of the nature of the intervention and outcomes measured. However, nurse-led interventions in general practice demonstrate significant potential to improve blood pressure and support cardiovascular disease risk factor reduction. Future research should be directed towards elucidating the successful elements of these interventions, evaluating cost-effectiveness and exploring translation into usual care. This review provides evidence that nurses in general practice could enhance current hypertension management through nurse-led interventions.

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“…Sample sizes ranged from 51 (Tonstad et al, 2007) to 1492 (Carrington et al, 2016) patients. The specific interventions reported across studies were varied and multifaceted.…”

Section: Resultsmentioning

confidence: 99%

Nurse‐led interventions to manage hypertension in general practice: A systematic review and meta‐analysis

Stephen

Halcomb

Fernandez

et al. 2022

Journal of Advanced Nursing

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“…Internationally, general practice nurses (GPNs) provide an important role in chronic disease management (CDM), including activities that support disease prevention and patient self‐management (Carrington et al, ; Eley et al, ). Despite variability in international primary care settings, many countries including Australia, New Zealand, and the UK have targeted funding and policy initiatives to enhance the number and develop the roles of GPNs to meet increasing patient need (Australian Medicare Local Alliance, ; Ministry of Health, ; Primary Care Workforce Commission, ; Swerissen et al, ).…”

Section: Introductionmentioning

confidence: 99%

Lifestyle risk factor communication by nurses in general practice: Understanding the interactional elements

James

McInnes

Halcomb

et al. 2019

Journal of Advanced Nursing

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Aim: This paper seeks to explore general practice nurses' perceptions of interactional factors supporting communication with patients about lifestyle risk. Design: Qualitative descriptive study embedded in a concurrent mixed methods design. Methods: Fifteen Australian general practice nurses were interviewed following video-recorded chronic disease management consultations Results: The theme of 'Interactional Factors' comprised of the subthemes 'Relational factors' and 'Patient factors'. Relational factors referred to communication techniques and methods supporting temporal continuity with patients about lifestyle risk. Patient factors included consumers' motivation, willingness, and readiness to prioritize lifestyle changes. Lack of awareness of the nurses' role was perceived to have an impact on initiation of lifestyle risk conversations. Conclusion: Strategies optimizing continuity of nursing care enhance the capacity for lifestyle risk reduction conversations with patients. Ongoing training in patient-centred communication and increasing patients' awareness of general practice nurses' roles would also better support these discussions. Impact: This research identifies ways the general practice nurses' role in supporting lifestyle risk reduction can be improved. Optimizing the general practice nurses' role in lifestyle risk communication can enhance the behaviour change and chronic disease management. K E Y W O R D S counselling, general practice, interactions, lifestyle, nursing, patient relations, primary care, qualitative descriptive, thematic analysis

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“…The finding of little differences between those who reported receiving medication, who have been diagnosed, or had a heart attack or angina in the preceding 5 years, and those who did not report such characteristics, is concerning. In a previous study we found that the availability of a practice nurse was a significant factor in achieving blood pressure targets in primary practice suggesting that busy general practitioners need additional support in helping their patients understand the need for achieving targets for risk factors ( Carrington et al, 2015 ). Finally, lack of awareness of the role of heart disease in population health have broader political implications through influencing funding decisions that reflect perceptions of importance in the community.…”

Section: Discussionmentioning

confidence: 99%

Australian adults' behaviours, knowledge and perceptions of risk factors for heart disease: A cross-sectional study

Hoare

Stavreski

Kingwell

et al. 2017

Preventive Medicine Reports

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This research aimed to determine Australian adults' perceptions of risk factors for heart disease, self-reported behaviours relating to modifiable risk factors, and knowledge of leading causes of death. This study reports on HeartWatch survey data collected between January 2015 and December 2015 in a sample of Australian adults. The setting of the research was Australian communities, with all states and territories represented in the final sample. Participants were Australian adults aged 30–59 years (n = 8425), and were representative of the wider Australian population based on key demographic and health characteristics. Half of the sample overall correctly identified heart disease as the biggest underlying cause of death of males, and 26% for women. For risk factors for heart disease, respondents most frequently reported; poor diet (58.2%, 95%CI 57.0–59.1), physical inactivity (49.0%, 95%CI 47.9–50.1) and smoking (38.7%, 95%CI 37.7–39.8). A low proportion (< 10%) recognised underlying clinical risk factors for heart disease including high blood pressure (6.3%, 95%CI 5.8–6.8) and dyslipidaemia (9.8%, 95%CI 9.2–10.5). This study revealed broad misconceptions with regard to the leading cause of death and risk factors for heart disease among Australian men and women. Overall the lack of understanding in all groups suggests the need for a comprehensive national campaign reaching schools and the broad adult population. The health system alone cannot achieve national and international targets for disease prevention without understanding and engagement in the general community.

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Impact of nurse-mediated management on achieving blood pressure goal levels in primary care: Insights from the Valsartan Intensified Primary carE Reduction of Blood Pressure Study

Abstract: There is greater potential to achieve blood pressure targets in primary care with practice nurse-mediated hypertension management.

Cited by 9 publications

References 22 publications

Nurse‐led interventions to manage hypertension in general practice: A systematic review and meta‐analysis

Nurse‐led interventions to manage hypertension in general practice: A systematic review and meta‐analysis

Lifestyle risk factor communication by nurses in general practice: Understanding the interactional elements

Australian adults' behaviours, knowledge and perceptions of risk factors for heart disease: A cross-sectional study

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