Wahab Kolawole Wasiu, Owolabi Mayowa, Akinyemi Rufus, Jenkins Carolyn, Arulogun Oyedunni, Akpa Onoja, Gebregziabher Mulugeta, Uvere Ezinne, Saulson Raelle, Ovbiagele Bruce
Department of Medicine, University of Ilorin, Ilorin, Nigeria.
Department of Medicine, University of Ibadan, Ibadan, Nigeria.
J Neurol Sci. 2017 Jun 15;377:116-120. doi: 10.1016/j.jns.2017.04.005. Epub 2017 Apr 7.
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.
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.
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.
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.
鉴于撒哈拉以南非洲地区（SSA）神经科医生短缺，将中风后护理工作转移给护士可能是改善中风后治疗效果的可行途径。这项试点研究评估了在尼日利亚，由护士主导的干预措施对近期中风幸存者进行血压控制管理的可行性和短期影响。
一项随机试点试验将来自尼日利亚两家参与医院的首次中风后一个月内的患者随机分配到护士主导的小组诊所或接受14天的标准护理。主要研究终点是方案的成功实施、受试者留存率和短期血压影响。
干预组（n = 17）和对照组（n = 18）在基线时无显著差异。在干预后的诊所，患者留存率为100%。在干预组中，在家测量的收缩压和舒张压均低于干预后诊所测量的血压（127±12.88/78.13±19.26mmHg对137.50±23.05/84.06±9.67mmHg；p = 0.05）。然而，干预组和对照组的诊所血压记录均无显著变化。
在SSA地区，开展由护士主导的小组诊所干预措施来管理中风幸存者的血压是可行的，且参与者早期留存率良好。正在计划开展一项更大规模、更长期的试验。
