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Title: 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
Austin Authors: Carrington, Melinda J;Jennings, Garry L;Harris, Mark;Nelson, Mark R;Schlaich, Markus;Stocks, Nigel P;Burrell, Louise M ;Amerena, John;de Looze, Ferdinandus J;Swemmer, Carla H;Kurstjens, Nicol P;Stewart, Simon
Affiliation: Austin Health, Heidelberg, Victoria, Australia
Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Western Australia, Australia
Discipline of General Practice, University of Adelaide, Adelaide, South Australia, Australia
Departments of Medicine and Cardiology, The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
Geelong Cardiology Research Department, Deakin University, Geelong, Victoria, Australia
School of Medicine, University of Queensland, St Lucia, Queensland, Australia
Novartis Pharmaceuticals Australia Ltd, Sydney, NSW, Australia
Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
Issue Date: Oct-2016
Date: 2015-06-18
Publication information: European Journal of Cardiology Nursing 2016; 15(6): 409-416
Abstract: Background: Blood pressure targets in individuals treated for hypertension in primary care remain difficult to attain. Aims: To assess the role of practice nurses in facilitating intensive and structured management to achieve ideal BP levels. Methods: We analysed outcome data from the Valsartan Intensified Primary carE Reduction of Blood Pressure Study. Patients were randomly allocated (2:1) to the study intervention or usual care. Within both groups, a practice nurse mediated the management of blood pressure for 439 patients with endpoint blood pressure data (n=1492). Patient management was categorised as: standard usual care (n=348, 23.3%); practice nurse-mediated usual care (n=156, 10.5%); standard intervention (n=705, 47.3%) and practice nurse-mediated intervention (n=283, 19.0%). Blood pressure goal attainment at 26-week follow-up was then compared. Results: Mean age was 59.3±12.0 years and 62% were men. Baseline blood pressure was similar in practice nurse-mediated (usual care or intervention) and standard care management patients (150 ± 16/88 ± 11 vs. 150 ± 17/89 ± 11 mmHg, respectively). Practice nurse-mediated patients had a stricter blood pressure goal of ⩽125/75 mmHg (33.7% vs. 27.3%, p=0.026). Practice nurse-mediated intervention patients achieved the greatest blood pressure falls and the highest level of blood pressure goal attainment (39.2%) compared with standard intervention (35.0%), practice nurse-mediated usual care (32.1%) and standard usual care (25.3%; p<0.001). Practice nurse-mediated intervention patients were almost two-fold more likely to achieve their blood pressure goal compared with standard usual care patients (adjusted odds ratio 1.92, 95% confidence interval 1.32 to 2.78; p=0.001). Conclusion: There is greater potential to achieve blood pressure targets in primary care with practice nurse-mediated hypertension management.
Description: on behalf of the VIPER-BP Study investigators
DOI: 10.1177/1474515115591901
ORCID: 0000-0003-1863-7539
Journal: European Journal of Cardiology Nursing
PubMed URL:
Type: Journal Article
Subjects: Nurse management
Blood pressure
Primary care
Appears in Collections:Journal articles

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