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

@entity917 @entity1 @entity101
BACKGROUND: Blood pressure targets in individuals treated for @entity101 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 @entity917 Intensified Primary carE Reduction of Blood Pressure Study. @entity1 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 @entity1 with endpoint blood pressure data (n=1492). @entity1 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 @entity1 . Baseline blood pressure was similar in practice nurse-mediated (usual care or intervention) and standard care management @entity1 (150    16/88    11 vs. 150    17/89    11 mmHg, respectively). Practice nurse-mediated @entity1 had a stricter blood pressure goal of    125/75 mmHg (33.7% vs. 27.3%, p=0.026). Practice nurse-mediated intervention @entity1 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 @entity1 were almost two-fold more likely to achieve their blood pressure goal compared with standard usual care @entity1 (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 @entity101 management.
