Effects of 8 weeks sustained follow-up after a nurse consultation on hypertension: A randomised trial

Background: The prevalence of hypertension is high, but the overall control rate is low. Poor control of, hypertension is associated with a number of diseases, such as stroke, heart and renal failure, and high, mortality rates. Studies have shown the separate effects of nurse clinics and telephone follow-up on, blood pressure control, but the incremental effect of combining the two interventions is unknown. Objectives: This study examines whether there is an incremental effect on blood pressure control when using a nurse clinic combined with telephone follow-up. Methods: This was a randomised controlled trial. The primary outcome measure was blood pressure reading. The secondary outcome measures included adherence to home blood pressure monitoring, exercise, diet, medication, and satisfaction with care. Results: There were no significant differences in the baseline measures between the control and study groups. Significant differences were found at 8 weeks after intervention was initiated between groups in, systolic blood pressure (control -7.97 vs study -19.03, t = 2.35, p = 0.022, CI 1.66-20.47) and diastolic, blood pressure (control -3.72 vs study -11.68, t = 3.02, p = 0.004, CI 2.68-13.24). Other variables with a significant between-group differences (p < 0.05) were blood pressure control rate, adherence, to home blood pressure monitoring, exercise and satisfaction with care. Further analysis using, regression showed that home blood pressure monitoring is the most significant predictor for improved, systolic blood pressure. Conclusions: This study showed that nurse clinics have positive effects on blood pressure control and adherence to healthy lifestyle, but telephone follow-up after such clinics augments the effects of the clinic consultation. This combined mode of services is worth considering for other chronic disease, management programmes. (C) 2010 Elsevier Ltd. All rights reserved.