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| Name | Class |
|---|---|
| URC-CIC Paris Descartes Necker Cochin | OTHER |
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Hypertension is the most frequent chronic pathology in France and in the world. It is one of the main modifiable cardiovascular risk factors. In France, 50% of treated hypertensives are uncontrolled and only 30% of treated patients are fully adherent to their antihypertensive treatment. Poor adherence to drug treatments is considered as one of the main causes of non-control of hypertension.
Since 2018, a new profession has entered the French healthcare system: Advanced Practice Nurses (APN). They have many broad skills, at the interface of nursing and medical exercises.
The purpose of this interventional study is to assess the impact of APN on blood pressure (BP) control in the context of usual care of hypertension thanks to a better adhesion of patients and a better therapeutic alliance.
The hypothesis formulated is that an individual APN intervention, included in a usual hypertension management, improves BP control.
Hypertension is the most frequent chronic pathology in France and in the world. It is one of the main modifiable cardiovascular risk factors. In France, 50% of treated hypertensives are uncontrolled and only 30% of treated patients are fully adherent to their antihypertensive treatment. Poor adherence to drug treatments is considered as one of the main causes of non-control of hypertension.
Since 2018, a new profession has entered the French healthcare system: Advanced Practice Nurses (APN). They have many broad skills, at the interface of nursing and medical exercises.
The purpose of this interventional study is to assess the impact of APN on blood pressure (BP) control in the context of usual care of hypertension thanks to a better adhesion of patients and a better therapeutic alliance.
The hypothesis formulated is that an individual APN intervention, included in a usual hypertension management, improves BP control.
This study will be a retrospective quasi-experimental study, conducted at the Diagnosis and Therapeutic Center of the Hôtel-Dieu University Hospital, Assistance Publique - Hôpitaux de Paris, France. The timeframe of the study should is from September 2020 to July 2023.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with APN intervention | Participants with a schedule of a MD consultation (within approximately 2 to 12 months) + an APN intervention halfway between day hospitalization et MD consultation |
| |
| Patients without APN intervention | Participants with a MD consultation only, within approximately 2 to 12 months |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| APN intervention | Other | Participants with a schedule of a MD consultation (within approximately 2 to 12 months) + an APN intervention halfway between day hospitalization et MD consultation APN intervention is divided into five main steps:
|
| Measure | Description | Time Frame |
|---|---|---|
| Blood pressure (BP) control | Blood pressure (BP) control in MD consultation
| Between 2 to 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Home blood pressure monitoring (HBPM) | Performance and quality of home BP monitoring (HBPM). 3-category variable: HBPM perfectly performed, HBPM poorly performed, and HBPM not performed. | Between 2 to 12 months |
| Blood pressure (BP) control |
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Inclusion Criteria:
Exclusion Criteria:
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Adults with essential hypertension, recruited in day hospitalization unit: HDJ CITE of the Hôtel-Dieu Hospital.
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| Name | Affiliation | Role |
|---|---|---|
| Jacques BLACHER, MD, PhD | Diagnosis and Therapeutic Center, Hôtel-Dieu University Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, 75004 Paris | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Diagnosis and Therapeutic Center, Hôtel-Dieu University Hospital, Assistance Publique-Hôpitaux de Paris | Paris | Île-de-France Region | 75004 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40346888 | Result | Vay-Demouy J, Lelong H, Blacher J. Advanced Practice Nurse Intervention Versus Usual Care for Hypertension Control: A Pilot Open-Label Randomized Controlled Trial. J Clin Hypertens (Greenwich). 2025 May;27(5):e70068. doi: 10.1111/jch.70068. |
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| D000074822 | Treatment Adherence and Compliance |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D015438 | Health Behavior |
| D001519 | Behavior |
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| No APN intervention | Other | Participants with a schedule of a MD consultation (within approximately 2 to 12 months) |
|
Evolution of BP control between day hospitalization and MD consultation. 3-category variable: now controlled, stable, no longer controlled
| Day hospitalization - Inclusion |
| Blood pressure (BP) control | Evolution of BP control between day hospitalization and MD consultation. 3-category variable: now controlled, stable, no longer controlled | Between 2 to 12 months |
| Therapeutic adjustments | Group with APN : Therapeutic adjustments and their indication(s) by the APN. Dichotomous variables: therapeutic adjustments (yes/no) and their indication(s): inefficacy (yes/no) and intolerance (yes/no). | Between 2 to 12 months |