Does Nurse-Led Medication Management Lower BP?
The use of electronic health record (EHR)-based medical management tools in addition to nurse-led self-management education may lower blood pressure (BP), when compared to using EHR tools alone, and may improve understanding of medication instructions and dosing, according to a study published July 9 in JAMA Internal Medicine.
Stephen D. Persell, MD, MPH, et al., looked at 794 patients with hypertension who self-reported using three or more medications concurrently. Patients were randomly assigned to three groups: EHR-alone group (comprised of medication review sheets at check-in and post-visit medication information sheets); EHR plus education group (comprised of EHR tools plus nurse-led medication management support); or usual care.
Results showed that after 12 months, the primary outcome of systolic BP was greater in the EHR-alone group compared with the usual care group by 3.6 mm Hg (95 percent CI, 0.3 to 6.9 mm Hg). Systolic BP in the EHR plus education group was not significantly lower compared with the usual care group (difference, −2.0 mm Hg; 95 percent CI, −5.2 to 1.3 mm Hg) but was lower compared with the EHR-alone group (−5.6 mm Hg; 95 percent CI, −8.8 to −2.4 mm Hg).
In addition, hypertension medication reconciliation was improved in both the EHR-alone group and the EHR plus education group compared with usual care. Further, understanding of medication instructions and dosing was greater in the EHR plus education group vs. the usual care group.
The authors add that moving forward, "self-administration errors, medication discrepancies, and incomplete adherence were common, leaving much room for improvement."
Keywords: Blood Pressure, Medication Reconciliation, Self Report, Self Administration, Hypertension, Pregnancy-Induced, Hypotension, Electronic Health Records
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