Blood Pressure Screenings Through Community Nursing Health Fairs: Motivating Individuals to Seek Health Care Follow-Up

ABSTRACTObjective: Hypertension (HTN) expends a consequential public health concern on cardiovascular health status and health-care systems in India. Theeffectuation of the pharmaceutical care program in the health care is an extremely important need to achieve the optimum therapeutic effect. Theobjective of the study was to assess the impact of pharmacist intervention on patient’s blood pressure (BP) level, quality of life (QOL), and knowledge,attitude, and practice (KAP) of hypertensive patients.Methods: A randomized controlled pilot study was carried out for 6 months. The hypertensive patients were randomized into control and interventiongroup based on age, and both the groups were interviewed using KAP and WHO QOL-BREF questionnaires, screened BP, respectively, at baseline andeach follow-up after post counseling section to the intervention group. The effect of pharmacist intervention on QOL and KAP among control andintervention was statistically analyzed by paired t-test using SPSS version 16.Results: The total sample studied was 60, of which 20 (33.33%) were males and 40 (66.67%) were females. In our study, the QOL score for eachdomain of both intervention and control groups were almost poor (p˃0.05) at baseline and for the intervention group, a highly significant improvement(p<0.001) was observed for all domains in final follow-up. KAP score of intervention group also showed a significant improvement (p<0.001) frombaseline to final follow-up. In this study, intervention group showed a significant mean reduction of systolic BP from baseline 150.13±25.670 to finalfollow-up 145.33±12.914.Conclusion: The results of the study showed a significant improvement in the patient’s KAP toward different aspects of HTN and QOL followingpharmacist mediated counseling. Involvement of pharmacy practitioners in the management of HTN significantly improves QOL and KAPs.Keywords: Hypertension, Quality of life, Knowledge, Attitude and practice, Pharmacist intervention, Patient counseling.

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The impact of routine follow-up with health care teams on blood pressure control among patients with hypertension

Journal of Human Hypertension ◽

10.1038/s41371-018-0158-7 ◽

2019 ◽

Vol 33 (6) ◽

pp. 466-474

Author(s):

Hui-Juan Zuo ◽

Ji-Xiang Ma ◽

Jin-Wen Wang ◽

Xiao-Rong Chen ◽

Lei Hou

Keyword(s):

Blood Pressure ◽

Health Care ◽

Blood Pressure Control ◽

Pressure Control ◽

Health Care Teams ◽

The Impact

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Abstract P124: My Unlimited Potential: Achieving Weight, Fitness And Cardio-metabolic Health Objectives Using A 12-week, Multicomponent, Behavioral Intervention

Circulation ◽

10.1161/circ.129.suppl_1.p124 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Maribeth Rouseff ◽

Thinh H Tran ◽

Khurram Nasir ◽

Josette Bou-Khalil ◽

Joseph J Mora ◽

...

Keyword(s):

Blood Pressure ◽

Health Care ◽

Exercise Capacity ◽

Behavioral Intervention ◽

Intervention Program ◽

South Florida ◽

Metabolic Risk ◽

Short Term ◽

Improvement Program

Background: With about 59% of the entire US population currently in the work force, American Heart Association has emphasized worksite-based interventions to improve cardiovascular health among the working population. The primary aim of this study was to assess the short-term (12 weeks) efficacy of an ongoing multi-component, behavioral intervention improvement program (My Unlimited Potential (myUP), among employees of Baptist Health South Florida (BHSF), a large not-for-profit health care system. Methods: BHSF employees with two or more Cardio-metabolic risk factors, such as total cholesterol ≥ 200 mg/dl, systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, hemoglobin A1C ≥ 6.5%, and body mass index (BMI) ≥ 30 were considered for the study. Behavioral interventions were focused on diet and physical activity modifications. Results: Overall 202 (48±10 years, 78% females) employees enrolled in myUP wellness program. The retention of subjects was high with 89% (n=181) of subjects following up at 12 weeks. The figure below demonstrates the baseline, follow-up and estimated mean change in anthropometric, exercise capacity on treadmill test and CM participants. BMI reduction >5% was noted in 38% of the participants. Significantly higher, clinically meaningful, endpoints, especially in attaining blood pressure goals and exercise capacity (>10 METS), during the short-term follow-up in this behavioral intervention program (figure), were achieved. Conclusion: These findings suggest that an intensive behavioral modification intervention program, delivered to employees in a health care setting, results in significant short term benefit in weight reduction, increase fitness level and concomitantly improve cardio-metabolic risk profile. Further follow-up is in progress to ascertain whether these benefits are sustainable over a longer duration.

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Community Nursing: Health Care for Today and Tomorrow

AJN American Journal of Nursing ◽

10.2307/3463691 ◽

1985 ◽

Vol 85 (1) ◽

pp. 102

Author(s):

Ruth Reagan Hutchison ◽

Mary Jo Dummer Clark

Keyword(s):

Health Care ◽

Community Nursing ◽

Nursing Health

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Evaluation and pilot implementation of essential interventions for the management of hypertension and prevention of cardiovascular diseases in primary health care in the Republic of Tajikistan

BMC Health Services Research ◽

10.1186/s12913-021-06490-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Dylan Collins ◽

Laura Inglin ◽

Tiina Laatikainen ◽

Mekhri Shoismatuloeva ◽

Dilorom Sultonova ◽

...

Keyword(s):

Blood Pressure ◽

Health Care ◽

Primary Health Care ◽

Blood Pressure Control ◽

Regression Models ◽

Pressure Control ◽

Primary Health ◽

Essential Interventions ◽

Clinical Records

Abstract Background The aim of this study was to determine the feasibility of implementing and evaluating essential interventions for the management of hypertension and prevention of cardiovascular disease in primary healthcare in Tajikistan. Methods The study protocol was published a priori. A pragmatic, sequential, mixed methods explanatory design was piloted. The quantitative strand is reported here. All primary health care facilities that met inclusion criteria in Shahrinav district were included and computer randomized to either usual care or intervention. The intervention consisted of: adaptation of WHO PEN/HEARTS clinical algorithms for hypertension and diabetes, a two-day training of doctors and nurses, supportive supervision visits, clinical decision support tools, and quality improvement support. Data were collected from paper-based clinical records at baseline and 12 months follow-up. The primary outcome was blood pressure control among patients with hypertension, in addition to several secondary process indicators along the care pathway. Age and sex adjusted logistic regression models were used for intervention and control clinics to determine changes between baseline and follow-up and to assess interactions between allocation group and time. For continuous variables, multivariate linear regression models were used. Results 19 primary health care centres were included of which ten were randomized to intervention and nine to control. 120 clinicians received training. The records of all registered hypertensive patients were reviewed at baseline and follow-up for a total of 1,085 patient records. Blood pressure control significantly improved in the intervention clinics (OR 3.556, 95 % CI 2.219, 5.696) but not the control clinics (OR 0.644, 95 % CI 0.370, 1.121) (p < 0.001 for interaction). Smoking assessment, statin prescribing, triple therapy prescribing, and blood pressure measurement significantly improved in intervention clinics relative to control, whereas cholesterol and glucose testing, and aspirin prescribing did not. Conclusions It is feasible to use routine, paper-based, clinical records to evaluate essential CVD interventions in primary health care in Tajikistan. Adapted WHO PEN/HEARTS guidelines in the context of a complex intervention significantly improved blood pressure control after 12 months.

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Implementation of a Personalized Care Plan for Patients With Type 2 Diabetes Is Associated With Improvements in Clinical Outcomes: An Observational Real-World Study

Journal of Primary Care & Community Health ◽

10.1177/2150132720921700 ◽

2020 ◽

Vol 11 ◽

pp. 215013272092170

Author(s):

Anni Vuohijoki ◽

Ilona Mikkola ◽

Jari Jokelainen ◽

Sirkka Keinänen-Kiukaanniemi ◽

Klas Winell ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Health Care ◽

Clinical Outcomes ◽

Real World ◽

Care Plan ◽

Personalized Care ◽

Primary Health

Objective: To analyze the clinical outcomes of patients with type 2 diabetes (T2D) before and after implementation of a personalized care plan in the primary health care setting. Design: Observational, retrospective, real-world study. Setting: All T2D patients with a care plan in Rovaniemi Health Center, Rovaniemi, Finland, for whom data were available from a baseline visit (in 2013-2015 during which the care plan was written) and from a follow-up visit, including an updated care plan by the year 2017. Subjects: In total, 447 patients were included. Mean age was 66.9 (SD 10.1) years, 58.8% were male, 15.4% were smokers, 33.1% had vascular disease, and 17.0% were receiving insulin treatment. The mean follow-up time was 14.4 months. Main Outcome Measures: Glycosylated hemoglobin A1 (HbA1c), low-density lipoprotein (LDL), blood pressure (BP), and body mass index (BMI). Clinical values were taken at both baseline and follow-up. Results: LDL decreased by 0.2 mmol/L, systolic blood pressure by 2.2 mm Hg, diastolic blood pressure by 1.5 mm Hg, and BMI by 0.5 kg/m2 ( P < .05 for each). The decrease in HbA1c was 0.8 mmol/mol ( P = .07). Conclusion: We observed statistically significant decreases in LDL, BP, and BMI. Our results indicate that, over 14 months of follow-up, implementation of a written care plan was associated with small improvements in the clinical outcomes of T2D patients in a primary health care study population in a real-world setting.

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Abstract 327: Six months follow-up of “My Unlimited Potential”, A 12-week Worksite, Multi-Component, Lifestyle Intervention for Improving Cardiometabolic Health in High Risk Persons

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.7.suppl_1.327 ◽

2014 ◽

Vol 7 (suppl_1) ◽

Author(s):

Maribeth Rouseff ◽

Ehimen Aneni ◽

Thinh H Tran ◽

Josette Bou-Khalil ◽

Joseph J Mora ◽

...

Keyword(s):

Blood Pressure ◽

Health Care ◽

Intervention Program ◽

Cardiovascular Health ◽

Heart Association ◽

South Florida ◽

Cardiometabolic Health ◽

Improvement Program ◽

Meaningful Improvement

Background: With about 59% of the entire US population currently in the work force, the American Heart Association has emphasized worksite-based interventions to improve cardiovascular health among the working population. The primary aim of this study was to assess effectiveness of an ongoing multi-component, lifestyle improvement program (My Unlimited Potential [MyUP]) extending into 6 months, among employees of Baptist Health South Florida (BHSF), a large not-for-profit health care system. Methods: BHSF employees with 2 or more Cardiometabolic risk factors, such as total cholesterol ≥ 200 mg/dl, systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, hemoglobin A1C ≥ 6.5%, and body mass index (BMI) ≥ 30 were considered for the study. Behavioral interventions were focused on dietary and physical activity modifications. Results: Overall 202 (48±10 years, 78% females) employees who enrolled in the MyUP wellness program. The retention of subjects was high with 89% (n=181) at 12 weeks and 80% (n=162) at 6 months. The table and figure below demonstrate the baseline, 12 week and 6 months averages in anthropometric and laboratory profile in participants. Comparing follow-up from 3 months to that at 6 months, clinically meaningful improvement in endpoints were especially noted for BMI, BP, HDL targets, and reducing burden of systemic inflammation (figure). Conclusion: These findings suggest that an intensive behavioral modification intervention program, delivered to employees in a health care setting, results in both significant short and intermediate term benefit in weight reduction, improved blood pressure control and hbA1c, and concomitantly improves cardio-metabolic risk profile. Further follow-up is in progress to ascertain whether these benefits are sustainable over longer periods.

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Getting to know a new protocol in hypertension care

Communication & Medicine ◽

10.1558/cam.37345 ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

Mona Lundin

Keyword(s):

Blood Pressure ◽

Digital Technology ◽

Interaction Analysis ◽

Medical Discourse ◽

Graphical Form ◽

Graph Data ◽

Average Blood Pressure ◽

Infrastructure Design

This study explores the use of a new protocol in hypertension care, in which continuous patient-generated data reported through digital technology are presented in graphical form and discussed in follow-up consultations with nurses. This protocol is part of an infrastructure design project in which patients and medical professionals are co-designers. The approach used for the study was interaction analysis, which rendered possible detailed in situ examination of local variations in how nurses relate to the protocol. The findings show three distinct engagements: (1) teasing out an average blood pressure, (2) working around the protocol and graph data and (3) delivering an analysis. It was discovered that the graphical representations structured the consultations to a great extent, and that nurses mostly referred to graphs that showed blood pressure values, which is a measurement central to the medical discourse of hypertension. However, it was also found that analysis of the data alone was not sufficient to engage patients: nurses' invisible and inclusion work through eliciting patients' narratives played an important role here. A conclusion of the study is that nurses and patients both need to be more thoroughly introduced to using protocols based on graphs for more productive consultations to be established.

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