Kolawole Wasiu Wahab1, Mayowa Owolabi2, Rufus Akinyemi2, Carolyn Jenkins3, Oyedunni Arulogun4, Onoja Akpa5, Mulugeta Gebregziabher6, Ezinne Uvere2, Raelle Saulson7, Bruce Ovbiagele7. 1. Department of Medicine, University of Ilorin, Ilorin, Nigeria. Electronic address: wahab.kw@unilorin.edu.ng. 2. Department of Medicine, University of Ibadan, Ibadan, Nigeria. 3. Department of Nursing, Medical University of South Carolina, Charleston, USA. 4. Department of Health Promotion and Education, University of Ibadan, Ibadan, Nigeria. 5. Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria. 6. Department of Public Health Sciences, Medical University of South Carolina, Charleston, USA. 7. Department of Neurology, Medical University of South Carolina, Charleston, USA.
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.
RCT Entities:
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.
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