Impact of Advanced Practical Nursing Intervention Versus Usual Care on Hypertension Control : Retrospective Single-center Quasi-experimental Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Hypertension
- Sponsor
- Assistance Publique - Hôpitaux de Paris
- Enrollment
- 483
- Locations
- 1
- Primary Endpoint
- Blood pressure (BP) control
- Status
- Completed
- Last Updated
- 7 months ago
Overview
Brief Summary
Hypertension is the most frequent chronic pathology in France and in the world. It is one of the main modifiable cardiovascular risk factors. In France, 50% of treated hypertensives are uncontrolled and only 30% of treated patients are fully adherent to their antihypertensive treatment. Poor adherence to drug treatments is considered as one of the main causes of non-control of hypertension.
Since 2018, a new profession has entered the French healthcare system: Advanced Practice Nurses (APN). They have many broad skills, at the interface of nursing and medical exercises.
The purpose of this interventional study is to assess the impact of APN on blood pressure (BP) control in the context of usual care of hypertension thanks to a better adhesion of patients and a better therapeutic alliance.
The hypothesis formulated is that an individual APN intervention, included in a usual hypertension management, improves BP control.
Detailed Description
Hypertension is the most frequent chronic pathology in France and in the world. It is one of the main modifiable cardiovascular risk factors. In France, 50% of treated hypertensives are uncontrolled and only 30% of treated patients are fully adherent to their antihypertensive treatment. Poor adherence to drug treatments is considered as one of the main causes of non-control of hypertension. Since 2018, a new profession has entered the French healthcare system: Advanced Practice Nurses (APN). They have many broad skills, at the interface of nursing and medical exercises. The purpose of this interventional study is to assess the impact of APN on blood pressure (BP) control in the context of usual care of hypertension thanks to a better adhesion of patients and a better therapeutic alliance. The hypothesis formulated is that an individual APN intervention, included in a usual hypertension management, improves BP control. This study will be a retrospective quasi-experimental study, conducted at the Diagnosis and Therapeutic Center of the Hôtel-Dieu University Hospital, Assistance Publique - Hôpitaux de Paris, France. The timeframe of the study should is from September 2020 to July 2023.
Investigators
Eligibility Criteria
Inclusion Criteria
- •adult patient
- •being diagnosed with essential hypertension,
- •being followed by a MD of the structure for hypertension management,
- •having received a proposition to meet an APN for hypertension management between the day hospitalization and the next MD consultation,
- •having received a loaned tensiometer with instructions during the day hospitalization and explanations for HBPM protocol.
Exclusion Criteria
- •being diagnosed with secondary hypertension,
- •having APN follow-up before the day hospitalization,
- •being lost to follow-up in the twelve months after the MD consultation
- •not having the BP measurement by OBPM for the day hospitalization (baseline) and/or the endline (endline),
- •pregnancy
- •under guardianship or tutorship
- •State Medical Help
Outcomes
Primary Outcomes
Blood pressure (BP) control
Time Frame: Between 2 to 12 months
Blood pressure (BP) control in MD consultation * Rate of BP control (BP \< 140/90 mmHg) * Mean (SD) of both systolic and diastolic BP
Secondary Outcomes
- Therapeutic adjustments(Between 2 to 12 months)
- Blood pressure (BP) control(Between 2 to 12 months)
- Home blood pressure monitoring (HBPM)(Between 2 to 12 months)