Short-term pilot feasibility study of a nurse-led intervention to improve blood pressure control after stroke in Nigeria

J Neurol Sci. 2017 Jun 15;377:116-120. doi: 10.1016/j.jns.2017.04.005. Epub 2017 Apr 7.

Abstract

Background: Given the paucity of neurologists in Sub-Saharan Africa (SSA), task-shifting post-stroke care to nurses could be a viable avenue for enhancing post-stroke outcomes. This pilot study assessed the feasibility and short-term impact of a nurse-led intervention to manage blood pressure (BP) control in recent stroke survivors in Nigeria.

Methods: A randomized pilot trial allocated patients within one month of an index stroke from two participating hospitals in Nigeria to either nurse-led group clinic or standard care for 14days. Key study endpoints were successful execution of the protocol, subject retention, and short-term BP effects.

Results: There were no significant differences between the intervention (n=17) and control (n=18) groups at baseline. At the post-intervention clinic, patient retention rate was 100%. In the intervention group, both the systolic and diastolic BPs measured at home were lower than the clinic BPs post-intervention (127±12.88/78.13±19.26mmHg versus 137.50±23.05/84.06±9.67mmHg; p=0.05). However, there was no significant change in clinic blood pressure (BP) recordings in both the intervention and control groups.

Conclusion: It is possible to initiate a nurse-led group clinic intervention to address BP management among stroke survivors in SSA with good early retention of participants. A larger and longer-term trial is being planned.

Keywords: Blood pressure; Nurse-led group clinic; Stroke; Sub-Saharan Africa; Task shifting.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects
  • Blood Pressure / physiology*
  • Blood Pressure Determination
  • Disability Evaluation
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nigeria / epidemiology
  • Outcome Assessment, Health Care
  • Pilot Projects
  • Practice Patterns, Nurses'*
  • Stroke / diagnostic imaging
  • Stroke / drug therapy*
  • Stroke / epidemiology
  • Stroke / nursing*

Substances

  • Antihypertensive Agents