Elsevier

The Lancet

Volume 314, Issue 8153, 1 December 1979, Pages 1175-1178
The Lancet

Occupational Health
WORK-SITE TREATMENT OF HYPERTENSION BY SPECIALLY TRAINED NURSES: A Controlled Trial

https://doi.org/10.1016/S0140-6736(79)92397-3Get rights and content

Abstract

The clinical efficacy of using specially trained nurses to treat hypertension at the patient's place of work was compared in a controlled trial with management by the patient's family doctor. The 457 study participants were selected from 21 906 volunteers in industry and government whose blood-pressure was screened. The nurses were allowed to prescribe and change drug therapy at the work site without prior physician approval. Patients randomly allocated to receive care at work were significantly more likely to be put on antihypertensive medications (94·7% vs 62·7%, to reach goal blood-pressure in the first six months (48·5% vs 27·5%), and to take the drugs prescribed (67·6% vs 49·1%). Only 6% of patients were dissatisfied with the care provided by the nurses. Thus provision of care at work by specially trained nurses was well accepted and resulted in significantly improved blood-pressure control and medication compliance among employees with asymptomatic and uncomplicated hypertension.

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    Similar to the most effective group, the five studies that showed no improvement in adherence23,46,50,60,62 were almost all conducted by health professionals. Hunt et al.46 reported the effect of pharmacist-managed hypertension, and Logan et al.23 described worksite hypertension management carried out by a nurse with physician support. Both had ESs very close to zero, as did Tsuyuki et al.,60 who examined the effect of lay person (research coordinator) phone calls in which adherence was reinforced and patients were referred to their physicians for questions or adherence concerns.

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