Nursing case management for people with hypertension in primary health care: A randomized controlled trial

Abstract

Introduction: Hypertension is a chronic disease that requires continuous and longterm care to prevent or delay the development of associated complications. Although various interventions for hypertension exist, case management in Brazil's primary healthcare is understudied. We examined nursing case management effectiveness for controlling blood pressure among Brazilian adults with hypertension in the public healthcare system.Method: A randomized controlled trial with a 12-month follow-up was conducted at a primary healthcare clinic in southern Brazil. Adult patients with hypertension were randomly allocated to intervention (n = 47) and usual care groups (n = 47). The nursing case management model includes nursing consultations, telephone contact, home visits, health education, and appropriate referrals. Patient outcomes (blood pressure, body mass index, waist circumference, quality of life, treatment adherence) were assessed at baseline and 6-and 12-month follow-up for the intervention group and at baseline and 12-month follow-up for the usual care group. Data were collected from only the intervention group at T6 to avoid contact between the researcher and the usual care group, and to check the care plan and modify it if necessary.

Effectiveness of Educational Interventions on Adherence to Lifestyle Modifications Among Hypertensive Patients: An Integrative Review

“…The study did not use any supportive methods that facilitated an exploration of the effect of combined education. Da Silva et al conducted a two-arm RCT in Brazil and combined individual and group educations with the use of phone calls as a supportive method [46]. Each control arm and intervention arm consisted of 47 participants and the interventions lasted for 12 months.…”

Integrated Health Care System Application in Patients With Hypertension and Diabetes: A Systematic Review and Meta-analysis

“…Sixteen articles were included in the risk-of-bias assessment (Figure 3). Fifteen of the articles (15,(20)(21)(22)(23)(24)(25)(26)(28)(29)(30)(31)(32)(33)(34) used the random group design, one article( 27) didn't elaborate on the random methods it used. Thirteen of them (15, 20-26, 28, 30-32, 34)…”

“…Another 7 articles (15,21,22,27,28,30,31) are focused on hypertension, and the integrated health care as the main intervention to be used. All of them have the same index: blood pressure (systolic and diastolic blood pressure) and six (15,21,22,27,28,31) have body mass index. Body mass index (BMI) is a classical index to assess the risk associate with hypertension(37).…”

“…Seven articles (15,21,22,27,28,30,31) reported patients' blood pressure after the integrated health care management intervention. Their results all showed a reduction in blood pressure from baseline in the intervention group.…”

Effectiveness of a nurse‐led, face‐to‐face health coaching intervention in enhancing activation and secondary outcomes of primary care users with chronic conditions

“…Regarding the factors that may influence the extent to which a person's activation improves, gender, age, depression, educational level, health-related quality of life (HRQoL), and multimorbidity have been suggested in the literature (Blakemore et al, 2016;Bos-Touwen et al, 2015;Overbeek et al, 2018;Wetzstein et al, 2020). Primary care is typically the first point of contact for people with chronic conditions, and it is therefore an ideal setting in which to address the goal of building activation (Mattei da Silva et al, 2020). Dineen-Griffin et al (2019) suggest that interventions for supporting self-management and, therefore, patient activation in primary care are most effective when they are delivered one-onone and face-to-face, are participative rather than didactic, and are structured and multicomponent.…”