Efficacy of the implementation of a nurse-led adherence protocol in older patients with hypertension in primary care centres
Hypertension
Randomisation will be performed at the level of the nursing professional (cluster randomisation). Within each participating primary care centre, nurses will be randomly allocated in a 1:1 ratio to either the intervention group or the control group (usual care). All eligible patients under the care of each nurse will be assigned to the same study arm as their nurse. The randomisation sequence will be generated centrally using a computer-generated random allocation sequence. Due to the nature of the intervention, blinding of nurses and patients is not feasible; however, outcome assessment will be performed using standardised instruments and routinely collected clinical data. A nurse-led mixed educational and behavioural intervention delivered in primary care, consisting of: 1. Training of nursing professionals in medication adherence and motivational interviewing 2. Structured motivational interview with patients 3. Systematic medication review 4. Lifestyle counselling (diet, physical activity, smoking, alcohol) 5. Reinforcement through telephone calls and home visits Duration of patient follow-up: 12 months
Current key inclusion criteria as of 29/05/2026: 1. Age ≥60 years 2. Diagnosis of arterial hypertension 3. Prescribed antihypertensive medication 4. Non-adherence according to the MMAS-4 standardized scoring method 5. At least one primary care visit in the previous year 6. Written informed consent _____ Previous key inclusion criteria: 1. Age ≥60 years 2. Diagnosis of arterial hypertension 3. Prescribed antihypertensive medication 4. Non-adherence (Morisky–Green score ≥1) 5. At least one primary care visit in the previous year 6. Written informed consent
1. Institutionalised patients 2. Life expectancy <12 months 3. Cognitive or physical conditions preventing participation