The SHIP-CARE primary care intervention reduced mean office blood pressure from 137/83 to 129/78 mmHg (p<0.001) and increased target attainment from 54% to 73% (p=0.003).
Does a team-based, patient-centered hypertension management model improve blood pressure control in adults with hypertension?
A team-based, patient-centered hypertension management model utilizing home BP monitoring and nurse-led digital follow-up significantly improved blood pressure control over six months.
Objective: Hypertension represents a major challenge in Swedish primary care, with increasing patient numbers, limited resources, and poor blood pressure (BP) control. Sustainable, patient-centred, and team-based care models are needed to improve health outcomes and resource efficiency. The SHIP-CARE (Sustainable Hypertension Management in Primary Health Care, ClinicalTrials.gov ID: NCT06580613) project evaluates new models for hypertension management in primary care in Sweden. Design and method: To explore the feasibility of the intervention, a pilot study was conducted at two primary health care centres (PHCCs) in southern Sweden. Adults with hypertension were followed for six months. The intervention included targeted education and a structured treatment protocol with a visual risk flowchart for professionals. Patients received group-based education, a home BP monitor, and maintained digital contact with a nurse for medication adjustments and follow-up. Nurses consulted physicians as needed, with annual physician visits reserved for patients at high cardiovascular risk or with complications. The main outcome of the pilot study was feasibility (recruitment of participants and loss to follow-up). Secondary outcomes included changes in blood pressure and cardiovascular risk factor levels, patients’ and staff's grade of satisfaction and knowledge, and health care costs. Data was collected at baseline and at follow-up after six months, also including questionnaires. Additionally, separate focus groups interviews were held with patients and professionals involved. Results: In total, 106 patients (mean age 68; 48% women) were followed for six months and 57% classified as high cardiovascular risk. Among the 99 patients who up until now completed the intervention, mean office BP declined from 137/83 to 129/78 mmHg (p <0.001), and the proportion achieving BP <140/90 mmHg increased from 54% to 73% (p = 0.003). Conclusions: The intervention appears to lower BP and improve target attainment, suggesting potential benefits for cardiovascular risk management and healthcare workflow. Results will inform the design of a larger cluster-randomised, controlled trial comparing PHCCs implementing SHIP-CARE with those using standard care. If successful, SHIP-CARE could improve BP control and working conditions, as well as cost-effectiveness, in primary care.
Andersson et al. (Fri,) conducted a other in Hypertension (n=106). SHIP-CARE model (targeted education, structured treatment protocol, home BP monitor, digital nurse contact) was evaluated on feasibility (recruitment of participants and loss to follow-up). The SHIP-CARE primary care intervention reduced mean office blood pressure from 137/83 to 129/78 mmHg (p<0.001) and increased target attainment from 54% to 73% (p=0.003).