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Nurse-Led Email Reminder for Hypertensive Patients
Research title and authors
The article under analysis is called Efficacy of a nurse-led email reminder program for cardiovascular prevention risk reduction in hypertensive patients: A randomized controlled trial. It was written by Cicolini et al. and published in 2013.
Research problem and purpose
The article targets the issue of hypertension management. The issue is addressed using email reminder. The purpose is to save time and effort. Nurses reach the patients on distance. Nurses ensure better condition management.
Literature review
The literature review is in the introduction. The authors review many sources. All of them are recent. All sources are relevant. The authors provide an issue background. The importance of CVD intervention is discussed. There is a need for improvement.
Research objectives, questions, or hypothesis
The objective is to assess NRP-e effectiveness. NRP-e is hypothesized as a cost-effective intervention. The rationale is the lack of such studies. Question: do patients benefit from NRP-e? Theory: NRP-e helps nurses and patients.
Variables
Variables: gender, age of the patients. More variables: BMI, alcohol consumption. The research focused on lifestylemain factors: diet, smoking, activity. The study measured intervention compliance. Biological variables: BP, blood glucose, cholesterol.
Design
Study design: a randomized controlled trial. Length: October 2011 May 2012. Location: Italian Hypertension Primary Care Center. The study met ethical concerns. It was approved by the Ethics Committee of the University of the Abruzzo Region.
Sample, population, and setting
Target population: adults diagnosed with hypertension. Inclusion criteria: knowing the Italian language. Additional criteria: having e-mail and phone. The participants signed informed consent. Sample: divided into intervention and control groups. Sampling: random; researchers were blinded. Setting: home (patients), hospital (nurses).
Intervention description
The educational program was developed. Intervention: delivered via email, phone. Time: 1-hour sessions 3-4 times a week. Content: advice on condition management. Other content: tips on lifestyle choices. Materials: table of food classification.
Measurements
Outcome assessment: during follow-up visits. Means used: validated questionnaires. Other means: lab testing (blood). Outcomes assessed: CVD risk factors. Factors measured: diet, glucose, physical activity. Other measurements: treatment adherence.
Data collection
Data obtained: via questionnaires. Lab data: from blood tests. Factors assessed: blood glucose, BP. More factors: BMI, lifestyle, and diet reports. Intervention compliance: the appearance at follow-ups.
Data analyses
Data analysis: using the ShapiroWilk test. Differences over time periods: t-test. For variables distributed non-normally: Kruskal Wallis test. For dichotomized variables: chi-square. Comparisons: Wilcoxon matched-pairs signed-ranks test.
Mean differences: Kruskal Wallis test.
Data presentation
Data was presented in a table. Each factor was calculated separately. Advantages: excellent visibility and comprehensiveness. Research design: presented via a graph. The graph showed each step of work with the sample.
Results of the study
The decrease in CVD risk factors found in both groups. Factor without change: salt intake. Intervention group: greater improvement. Namely: BMI, BP, diet, lifestyle. Intervention group: better results in every factor. Intervention made no effect on salt intake.
Interpretation of findings
NRP-e is very effective for patients. Statistically better results in the intervention group. Conclusion: NRP-e works for each CVD factor. Results agree with previous findings. Compared to other studies: it affected more factors.
Limitations
The time of follow-up provision was short. No long-term assessment was conducted. No knowledge of the effects on major outcomes. Namely: stroke, myocardial infarction rates.
Implications
NRP-e is helpful for nurses. NRP-e allows for better workplace flexibility. It requires little time and effort. Nurses produce better effects. Conclusion: NRP-e is cost-effective.
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