Sustainable Hypertension Management in Primary Health Care in Sweden (SHIP-CARE)

Region Skane

Status: Enrolling

Conditions: Hypertension

Treatments: Other: Control; Other: New model of Hypertension Management

Study type: Interventional

Funder types: Other

Identifiers

NCT06580613

2024-03625-01

Details and patient eligibility

About

New sustainable models of patient-focused and team-based care for patients with hypertension should be developed to achieve health improvements and cost-efficiency.

The aim of this project is to evaluate new ways of sustainable hypertension (HT) management in primary care, starting with a pilot study at 2 Primary Health Care Centres (PHCCs).

At intervention PHCCs cardiovascular risk is assessed with SCORE2 for all hypertension patients. The staff receives education on HT treatment and an easy-to-follow treatment protocol. Non-physicians lead patient education on HT in groups. Patients receive a home blood pressure (BP) monitor and communicate digitally with the assigned nurse on medication update, blood and urinary tests and follow up. The nurse consults with the physician if needed. Regular face to face visits with the physician are only scheduled for patients with high cardiovascular risk or end organ damage, otherwise for all patients if needed.

At the control PHCs hypertension care continues as usual. All participants will be asked to complete questionnaires after 6 and 24 months.

Outcomes are feasibility for the pilot study and the proportion of patients reaching BP target plus change in systolic BP, cardiovascular risk factors, patients´ and staff´s grade of satisfaction and knowledge, and health care costs for the main study, compared between intervention and control PHCCS. Results will help to establish sustainable models of treating HT patients in Primary Care.

Enrollment: 500 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients with hypertension

Exclusion criteria

• secondary hypertension according to the medical records at the Primary Health Care Center
• terminal illness
• pregnancy-induced hypertension
• cognitive impairment
• impaired vision (not able to read measurements for the home BP measurements or communicate via "1177 direct" digitally)
• psychotic disorder

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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500 participants in 2 patient groups

Control

Active Comparator group

Description:

At the Control Primary Health Care Centers care continues as usual

Treatment:

Other: Control

Intervention

Experimental group

Description:

Hypertension management based on cardiovascular risk assessment. Low/medium risk: Digital contact with nurse, contact with GP only if needed High risk: Planned contacts with GP Group education on Hypertension for staff and participants

Treatment:

Other: New model of Hypertension Management