Effect of Nurse-Based Management of Hypertension in Rural Western Kenya
| Autor: | Samantha Raymond, Emilia Bagiella, Valentin Fuster, Jemima H. Kamano, Charity Wambui, Sylvester Kimaiyo, Anirudh Kumar, Rajesh Vedanthan, Deborah Tulienge, Helena Chang, Kenneth Too |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Rural Population lcsh:Diseases of the circulatory (Cardiovascular) system hypertension Epidemiology task redistribution global health 030204 cardiovascular system & hematology Elevated blood Retrospective data 03 medical and health sciences symbols.namesake 0302 clinical medicine Nursing Global health Medicine Humans 030212 general & internal medicine Poisson regression low- and middle-income countries Antihypertensive Agents Cause of death Original Research Retrospective Studies Community and Home Care nurse management business.industry lcsh:Public aspects of medicine Significant difference blood pressure Disease Management lcsh:RA1-1270 Middle Aged Prognosis Kenya Blood pressure lcsh:RC666-701 Cohort symbols Female Morbidity Cardiology and Cardiovascular Medicine business |
| Zdroj: | Global Heart Global Heart, Vol 15, Iss 1 (2020) Global Heart; Vol 15, No 1 (2020); 77 |
| ISSN: | 2211-8179 2211-8160 |
| Popis: | Background: Elevated blood pressure is the leading cause of death worldwide; however, treatment and control rates remain very low. An expanding literature supports the strategy of task redistribution of hypertension care to nurses. Objective: We aimed to evaluate the effect of a nurse-based hypertension management program in Kenya. Methods: We conducted a retrospective data analysis of patients with hypertension who initiated nurse-based hypertension management care between January 1, 2011, and October 31, 2013. The primary outcome measure was change in systolic blood pressure (SBP) over one year, analyzed using piecewise linear mixed-effect models with a cut point at 3 months. The primary comparison of interest was care provided by nurses versus clinical officers. Secondary outcomes were change in diastolic blood pressure (DBP) over one year, and blood pressure control analyzed using a zero-inflated Poisson model. Results: The cohort consisted of 1051 adult patients (mean age 61 years; 65% women). SBP decreased significantly from baseline to three months (nurse-managed patients: slope –4.95 mmHg/month; clinical officer-managed patients: slope –5.28), with no significant difference between groups. DBP also significantly decreased from baseline to three months with no difference between provider groups. Retention in care at 12 months was 42%. Conclusions: Nurse-managed hypertension care can significantly improve blood pressure. However, retention in care remains a challenge. If these results are reproduced in prospective trial settings with improvements in retention in care, this could be an effective strategy for hypertension care worldwide. |
| Databáze: | OpenAIRE |
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