Sustainable Hypertension Management in Primary Health Care in Sweden
- Conditions
- Hypertension
- Registration Number
- NCT06580613
- Lead Sponsor
- Region Skane
- Brief Summary
New sustainable models of patient-focused and team-based care for patients with hypertension should be developed to achieve health improvements and cost-efficiency.
The aim of this project is to evaluate new ways of sustainable hypertension (HT) management in primary care, starting with a pilot study at 2 Primary Health Care Centres (PHCCs).
At intervention PHCCs cardiovascular risk is assessed with SCORE2 for all hypertension patients. The staff receives education on HT treatment and an easy-to-follow treatment protocol. Non-physicians lead patient education on HT in groups. Patients receive a home blood pressure (BP) monitor and communicate digitally with the assigned nurse on medication update, blood and urinary tests and follow up. The nurse consults with the physician if needed. Regular face to face visits with the physician are only scheduled for patients with high cardiovascular risk or end organ damage, otherwise for all patients if needed.
At the control PHCs hypertension care continues as usual. All participants will be asked to complete questionnaires after 6 and 24 months.
Outcomes are feasibility for the pilot study and the proportion of patients reaching BP target plus change in systolic BP, cardiovascular risk factors, patients´ and staff´s grade of satisfaction and knowledge, and health care costs for the main study, compared between intervention and control PHCCS. Results will help to establish sustainable models of treating HT patients in Primary Care.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 500
- Adult patients with hypertension
- secondary hypertension according to the medical records at the Primary Health Care Center
- terminal illness
- pregnancy-induced hypertension
- cognitive impairment
- impaired vision (not able to read measurements for the home BP measurements or communicate via "1177 direct" digitally)
- psychotic disorder
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Blood pressure change 24 months change in proportion of patients reaching blood pressure target of \<140/90 mmHg
- Secondary Outcome Measures
Name Time Method Health economic evaluation 24 months Estimation of the ICER values (cost per unit of effect). Calculation of QALY, based on EQ5D (questionnaires). Comparison of ICER per QALY with values from the National Board of Health and Welfare
Participants grade of satisfaction 24 months Questionnaires. 7 point Likert Scale: Level of Satisfaction - 7 point
1. - Completely dissatisfied
2. - Mostly dissatisfied
3. - Somewhat dissatisfied
4. - neither satisfied or dissatisfied
5. - Somewhat satisfied
6. - Mostly satisfied
7. - Completely satisfiedStaffs grade of satisfaction 24 months Questionnaires. 7 point Likert Scale: Level of Satisfaction - 7 point
1. - Completely dissatisfied
2. - Mostly dissatisfied
3. - Somewhat dissatisfied
4. - neither satisfied or dissatisfied
5. - Somewhat satisfied
6. - Mostly satisfied
7. - Completely satisfiedBlood glucose level and cholesterol 24 months Change in mean blood glucose level (mmol/l), mean LDL-cholesterol (mmol/l), mean HDL-cholesterol (mmol/l)
Kidney function 24 months Change in mean eGFR (ml/min/1,73 m2)
Kidney complications 24 months Change in % of patients with microalbuminuria (U-albumin/kreatinin-kvot (mg/mmol) 3,0-30)
Smoking 24 months Change in % of patients who smoke)
Trial Locations
- Locations (1)
Husensjö Primary Health Care Center
🇸🇪Helsingborg, Sweden