This review seeks to critically appraise randomised controlled trials that investigate the effectiveness of nursing interventions in modifying lifestyle risk factors by a practice nurse within those with hypertension in the general practice setting.
Methods:
A systematic review was undertaken to identified published, peer-reviewed Randomised Controlled Trails of general practice nurse led interventions for prevention of cardiovascular disease. The inclusion criteria were:
- Participants: Registered Nurses working in general practice and their patients
- Study design: Studies were only included if they were a randomised controlled
- Interventions: a primarily nursing delivered intervention within a general practice or primary care setting which targeted reduction of blood pressure in patients who were hypertensive. Papers were excluded if the nurse was a nurse practitioner or a specialist cardiac
Outcomes: all outcomes relating to improvement in health status and lifestyle risk factor profile were included (e.g. blood pressure, cholesterol, smoking status, body weight).
Results:
In total 11 papers met the inclusion criteria and were included for this review. Studies originated from, Australia, America, Italy, Netherlands, Turkey, Germany, Norway, Sweden, and Finland. Six studies included patients with hypertension at baseline whilst the other five included participants who had a previous diagnosis of hypertension regardless of whether their blood pressure was currently under control. Sample sizes ranged from 51 to 1492 patients. One study measured outcomes at 26 weeks, five studies measured outcomes at one year, whilst the other studies measured outcomes at 3, 6, 18 and 24 months.
Conclusion:
Nurse-led interventions to optimise hypertension management in general practice are globally heterogeneous. Variation within this evidence base makes definitive conclusion elusive however, nurse interventions in general practice show significant potential to improve BP control and support individuals to achieve enhanced health outcomes. Before the model can be effectively embedded within the general practice landscape, further investigation into the professional, economic and health implications of reorganising care is required.