Feasibility and acceptability of a nurse-led hypertension management intervention in general practice
Background: Hypertension is the most frequently seen condition in Australian general practice. Despite the availability of effective therapies, many hypertensive individuals struggle to maintain adequate blood pressure control and are at increased risk of cardiovascular disease and premature morbidity. As such there is an urgent need for research to identify evidence based strategies to improve hypertension management in general practice. General Practice Nurses (GPNs) are conceptually ideally placed to support consumers to receive best practice care and achieve behavioural change. However, their specific role in managing hypertension is unclear. The purpose of this paper is to evaluate the acceptability and feasibility of a GPN-led intervention to manage hypertension in Australian general practice.
Methods: Individuals with uncontrolled hypertension were identified from electronic medical records. GPNs provided 4 face-to-face appointments and 2 telephone support calls to deliver the intervention.Qualitative evaluation of the interventions’ feasibility and acceptability was achieved through semi-structured interviews with 6 GPs, 7 GPNs and 12 consumers.
Findings: Thematic analysis revealed 5 themes, namely; pre-intervention training, GP/GPN roles, time and workload, acceptability and feasibility. Most GPNs appreciated the pre-intervention training, however the need for additional motivational interviewing education was identified. Consumers were satisfied with the intervention valuing the GPN as a ‘coach’, although they valued ongoing GP input. Issues relating to lack of time and competing work priorities were identified as barriers to successfully delivering the intervention, however, the intervention was perceived to be feasible and acceptable in practice.
Conclusion: Despite the demonstrated acceptability and feasibility of the intervention, the ongoing sustainability of the model rests largely upon overcoming the organisational, educational and professional barriers that constrain the GPN’s role. Findings demonstrate great potential for GPNs to significantly contribute to improved health outcomes and play a more active role in hypertension management. This role could be optimised with the development of motivational interviewing skills, enhanced GP/GPN collaborative practice and increased opportunity for consumer follow up.