Effectiveness of a family nurse‐led programme on accuracy of blood pressure self‐measurement: A randomised controlled trial

Simonetti, Valentina, Comparcini, Dania, Tomietto, Marco, Pavone, Daniele, Flacco, Maria Elena and Cicolini, Giancarlo (2021) Effectiveness of a family nurse‐led programme on accuracy of blood pressure self‐measurement: A randomised controlled trial. Journal of Clinical Nursing, 30 (15-16). pp. 2409-2419. ISSN 0962-1067

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Abstract

Aims and objectives: To evaluate the effectiveness of a Family Nurse Practitioner (FNP)-led programme on the degree of adherence of current recommendations on home blood pressure self-measurement (HBPM) as compared to routine care and management. Background: HBPM plays an important role for monitoring hypertensive patients; however, patients’ adherence to current guidelines is unsatisfactory. A nurse-led training programme in the community setting could be an effective strategy to achieve high level of patients’ adherence to recommendations. Design: A multicentre randomised controlled trial was carried out from September 2016 to September 2017.MethodsIn total, 170 patients were randomly allocated into the intervention group (n = 83) and the usual care (n = 87). All participants received usual care (written and verbal information on HBPM recommendations); subjects in the intervention group also received 1-hour training session on how to correctly self-measure BP. Clinical trial registration was done (ClinicalTrials.gov.: NCT04681703). The CONSORT checklist for randomised controlled trials was used in this study. Results: At baseline, the level of adherence to the recommendation was similar in the two groups (p < .05). After 1 month, the adherence significantly increased in the intervention group, where patients were more likely to measure BP at the same hour and from the same arm, in a quiet environment, with the back and uncovered arm supported and the legs uncrossed; recording BP more than once in each measurement session; keeping a diary of blood pressure measurements; use of the appropriate cuff and proper placement of the cuff; and resting for >5 min before performing the measurement (all p < .05). Conclusions: The FNP-led programme is effective in improving patients’ adherence to guidelines on the correct technique to self-measure BP at home.
Relevance to clinical practice: This programme may be added to the existing interventions in the community setting or considered into specifically nurse-led hypertension management models.

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