Key result
Nurse-managed care shows no significant improvement in blood pressure control over standard care.
Why the study?
The study aimed to investigate whether primary health care centers offering nurse-managed hypertension care differ from centers with other models of care regarding blood pressure levels and key follow-up indicators.
Does nurse-managed hypertension care improve blood pressure control and key follow-up indicators in patients with hypertension compared to non-nurse-managed care?
Cross-Sectional (n=119,267)
Yes
Does nurse-managed hypertension care improve blood pressure control and key follow-up indicators in patients with hypertension compared to non-nurse-managed care?
Nurse-managed hypertension care in primary care centers is as effective as non-nurse-managed care for achieving blood pressure targets and maintaining key quality indicators.
Similar BP control with nurse-managed care; hypothesis-generating and leaves open confirmation in randomized trials.
The study aimed to investigate if primary health care centers (PHCCs) offering nurse-managed hypertensive care differ from PHCCs with other types of hypertension care regarding blood pressure levels and other key indicators. In this cross-sectional study of the hypertension care given in PHCCs in Stockholm County (now called Region Stockholm), we included all 227 PHCCs in the region. To assess the extent of nurses' involvement in the PHCCs hypertension care, a questionnaire was distributed to all PHCCs in Region Stockholm. Data on blood pressure levels was collected from a primary health care quality system (Primary Care Quality). Data on key indicators regarding follow-up was obtained from the Region Stockholm database on follow-up (LUD). Blood pressure levels and LUD-data were then analyzed with regards to whether the PHCC had nurse-managed hypertension care or not. Our analysis comprised 119 267 patients diagnosed with hypertension registered in any of the regions 227 PHCCs. Of the 81 PHCCs that responded to the questionnaire, 55 reported having nurse-managed hypertension care, and 26 were classified as having non-nurse managed hypertension care, while 146 were classified as unknown type of hypertension care. There were no differences in patients reaching desired blood pressure levels between nurse-managed and non-nurse-managed hypertension care. Nurse-led hypertension care units were on par with the other types of PHCCs. Thus, nurse-led hypertension care seems to be as safe and effective as other types of hypertension care in PHCCs.
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Ivarsson et al. (2025) conducted a cross-sectional in Hypertension (n=119,267). Nurse-managed hypertension care vs. Non-nurse-managed hypertension care was evaluated on Proportion of patients with blood pressure ≤140/90 mmHg (p=0.06). Nurse-managed hypertension care resulted in similar rates of blood pressure control (≤140/90 mmHg) compared to non-nurse-managed care (median proportion 0.59 vs 0.58, p=0.06).
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