Impact of Advanced Practical Nursing Intervention Versus Usual Care on Hypertension Control : Retrospective Study (iIPArétro)

Assistance Publique - Hôpitaux de Paris

Status: Not yet enrolling

Conditions: Hypertension

Treatments: Other: No APN intervention; Other: APN intervention

Study type: Observational

Funder types: Other

Identifiers

NCT06227884

APHP231667

Details and patient eligibility

About

Hypertension is the most frequent chronic pathology in France and in the world. It is one of the main modifiable cardiovascular risk factors. In France, 50% of treated hypertensives are uncontrolled and only 30% of treated patients are fully adherent to their antihypertensive treatment. Poor adherence to drug treatments is considered as one of the main causes of non-control of hypertension.

Since 2018, a new profession has entered the French healthcare system: Advanced Practice Nurses (APN). They have many broad skills, at the interface of nursing and medical exercises.

The purpose of this interventional study is to assess the impact of APN on blood pressure (BP) control in the context of usual care of hypertension thanks to a better adhesion of patients and a better therapeutic alliance.

The hypothesis formulated is that an individual APN intervention, included in a usual hypertension management, improves BP control.

Full description

Hypertension is the most frequent chronic pathology in France and in the world. It is one of the main modifiable cardiovascular risk factors. In France, 50% of treated hypertensives are uncontrolled and only 30% of treated patients are fully adherent to their antihypertensive treatment. Poor adherence to drug treatments is considered as one of the main causes of non-control of hypertension.

Since 2018, a new profession has entered the French healthcare system: Advanced Practice Nurses (APN). They have many broad skills, at the interface of nursing and medical exercises.

The purpose of this interventional study is to assess the impact of APN on blood pressure (BP) control in the context of usual care of hypertension thanks to a better adhesion of patients and a better therapeutic alliance.

The hypothesis formulated is that an individual APN intervention, included in a usual hypertension management, improves BP control.

This study will be a retrospective quasi-experimental study, conducted at the Diagnosis and Therapeutic Center of the Hôtel-Dieu University Hospital, Assistance Publique - Hôpitaux de Paris, France. The timeframe of the study should is from September 2020 to July 2023.

Enrollment: 400 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• adult patient
• being diagnosed with essential hypertension,
• being followed by a MD of the structure for hypertension management,
• having received a proposition to meet an APN for hypertension management between the day hospitalization and the next MD consultation,
• having received a loaned tensiometer with instructions during the day hospitalization and explanations for HBPM protocol.

Exclusion criteria

• being diagnosed with secondary hypertension,
• having APN follow-up before the day hospitalization,
• being lost to follow-up in the twelve months after the MD consultation
• not having the BP measurement by OBPM for the day hospitalization (baseline) and/or the endline (endline),
• pregnancy
• under guardianship or tutorship
• State Medical Help

Trial design

400 participants in 2 patient groups

Patients with APN intervention

Description:

Participants with a schedule of a MD consultation (within approximately 2 to 12 months) + an APN intervention halfway between day hospitalization et MD consultation

Treatment:

Other: APN intervention

Patients without APN intervention

Description:

Participants with a MD consultation only, within approximately 2 to 12 months

Treatment:

Other: No APN intervention