The Impact of Intake Assessment and Nurse Clinic of Risk Assessment and Management Programme-Hypertension on Self-Management of Hypertensive Patients

Abstract Description

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Authors (including presenting author) :

Mak CL, Wong KW, Wong AL, Chan PF, Yee YT, Chao DVK

Affiliation :

Department of Family Medicine and Primary Health Care, United Christian Hospital and Tseung Kwan O Hospital, Kowloon East Cluster (KEC)

Introduction :

Risk Assessment and Management Programme – Hypertension (RAMP-HT) has been launched in KEC General Out-patient Clinics (GOPCs) since October 2011. The services provided include intake assessment (IA) and nurse clinic (NC). During IA, trained nurses would perform cardiovascular risk and complications assessment and risk stratification, and provide individual health counselling and education; while in NC, more intensive nursing intervention and patient empowerment would be provided. This study was conducted to examine the patients’ outcomes in self-management after receiving the nursing intervention.

Objectives :

To evaluate the effect of IA and NC on blood pressure control and self-management skills (home blood pressure monitoring, drug adherence, low salt diet and regular aerobic exercise) of hypertensive patients.

Methodology :

Hypertensive patients who were referred to NC after IA from November 2017 to October 2018 were recruited. Before-after study design was employed to evaluate the effect of the programme on clinical outcomes. Relevant data were retrieved from HA’s data warehouse (CDARS) and by record review.

Result & Outcome :

291 subjects were recruited. The mean age of the subjects was 65.6 years old. 50.9% (n = 148) were male. 90.7% (n = 264), 15.1% (n = 44) and 26.8% (n = 78) were referred to NC for suboptimal blood pressure control, drug compliance problems, and newly diagnosed hypertension respectively. Proportion of patients attaining target blood pressure (< 140/90 mmHg) increased from 5.2% during IA to 63.9% on discharge from NC (p < 0.001). The NC also empowered the patients on home blood pressure monitoring (increased from 64.9% to 84.2%, p< 0.001), good drug adherence (increased from 80.9% to 90.4%, p< 0.001), low salt diet (increased from 52.6% to 67.4%, p< 0.001) and regular aerobic exercise (increased from 12.7% to 21.6%, p< 0.002). The study showed that nursing intervention provided by RAMP-HT nurses had a significant positive effect on blood pressure control as well as patients’ self-management skills.