Hypertension effects over one third of all Australian adults (National Heart Foundation of Australia 2016).
While effective treatment is available, up to 60% of those living with hypertension struggle to keep their blood pressure under control and are at increased risk of renal failure, cardiovascular disease and premature death (Cadilhac et al. 2012; Australian Institute of Health and Welfare 2015).
Given that many of these individuals seek help within General Practice, nurses in this setting have a key role to play in supporting self-management and lifestyle risk factor reduction.
The ImPress study seeks to build on our previous pilot study (Zwar et al. 2017; Stephen et al. 2017) and test the impact of an innovative general practice nurse (GPN)- delivered intervention for patients with uncontrolled hypertension. The Clinical Audit Tool (CAT) will be used to identify patients who are at high risk of cardiovascular disease (National Vascular Disease Prevention Alliance 2012) and whose blood pressure is uncontrolled. These patients will be offered six face to face consultations and telephone support with the GPN over six months. During these consultations GPNs work in partnership with the patient and GP to provide tailored lifestyle advice, action planning, health monitoring and motivational counselling. Participants will also have GP input to optimise their medication in line with best practice. The primary outcome measure will be blood pressure and secondary outcomes will include lifestyle risk factors such as smoking, nutrition, body mass index and medication adherence.
This randomised controlled trial will be undertaken by Ms Catherine Stephen in her doctoral program at the University of Wollongong, School of Nursing. The research will be supervised by Professor Elizabeth Halcomb, Professor Nicholas Zwar and Dr Sue McInnes. We are currently recruiting 20 general practices who employ a registered nurse across Central Sydney and South Western Sydney Primary Health Networks. Once recruited practices will be randomised to either the intervention or the control group.
The ImPress intervention not only enhances the nurses’ role within general practice to the top of their scope, but also has the potential to improve health outcomes for individuals with hypertension. Results from this study will provide important evidence about the impact of a nurse delivered intervention on health outcomes in those with uncontrolled hypertension. This has the potential to change the way hypertension care is organised and delivered within Australian General Practice.
Further Details
The ImPress study has been approved by the UOW Human Research Ethics Committee. If you would like any further information or details on how you can participate contact Catherine via email at: cms793@uowmail.edu.au
Reference
- Australian Institute of Health and Welfare. 2015. Cardiovascular disease, diabetes and chronic kidney disease. Series no. 4. Cat. no. CDK 4., Vol. 2015 AIHW, Canberra.
- Cadilhac, D.A., Carter, R., Thrift, A.G. & Dewey, H.M. 2012. Organized blood pressure control programs to prevent stroke in australia: would they be cost-effective? Stroke 43(5), 1370-1375.
- National Heart Foundation of Australia. 2016. Guideline for the diagnosis and management of hypertention in adults – 2016. In National Heart Foundation of Australia,Melbourne.
- National Vascular Disease Prevention Alliance. 2012. Guidelines for the management of Absolute cardiovascular disease risk.
- Stephen, C.M., Hermiz, O.S., Halcomb, E.J., McInnes, S. & Zwar, N. 2017. Feasibility and acceptability of a nurse-led hypertension management intervention in general practice. Collegian.
- Zwar, N., Hermiz, O., Halcomb, E., Davidson, P. & Bodenheimer, T. 2017. Improving blood pressure control in general practice: A pilot study of the ImPress intervention. Australian Family Physician, 46(5), 306.
Catherine Stephen is a PhD Candidate in the School of Nursing at the University of Wollongong NSW
