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Evidence-Based Medicine 2006;11:92; doi:10.1136/ebm.11.3.92
Copyright © 2006 by the BMJ Publishing Group Ltd.
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Quality improvement

Review: care assisted by nurses or pharmacists provides better blood pressure control

Fahey T, Schroeder K, Ebrahim S. Educational and organisational interventions used to improve the management of hypertension in primary care: a systematic review. Br J Gen Pract 2005;55:875–82.[Medline]

Q In patients receiving treatment for hypertension, which organisational or educational strategies are effective for improving blood pressure (BP) control or clinical outcomes?

Clinical impact ratings GP/FP/Primary care ******{star} IM/Ambulatory care*****{star}{star}

Key Words: antihypertensive agents, family practice, hypertension, patient education

The first 150 words of the full text of this article appear below.

METHODS
Formula Data sources Cochrane Controlled Trials Register, Medline, and EMBASE/Excerpta Medica (to August 2004); references of relevant studies; and experts in the field.

Formula Study selection and assessment randomised controlled trials (RCTs) that compared interventions aimed at improving BP with no intervention or usual care in patients with treated or untreated essential hypertension and assessed mean systolic (SBP) or diastolic BP (DBP), control of BP, or proportion of patients followed up at clinic. Studies of interventions not intended to increase BP control by organisational or educational means (eg, drug trials) were excluded. 56 RCTs met the selection criteria. Methodological quality of the trials was poor to moderate. The interventions studied were self monitoring (15 RCTs), patient education (16 RCTs), health professional education (9 RCTs), care assisted by nurses or pharmacists (7 RCTs), organisational interventions (7 RCTs), and appointment reminders (6 RCTs). Quality assessment of individual studies included randomisation procedure; allocation concealment; blinding . . . [Full text of this article]

David Gutknecht, MD

Geisinger Medical Center
Danville, Pennsylvania, USA






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