Improving Blood Pressure in Adults 65 Years and Older via Weekly Telehealth Coaching

Abstract

Practice Problem: Hypertension is a significant modifiable risk factor for CVD and is on the rise with advancing age. The management at the VA hospital's GEC clinic acknowledged the importance of managing HTN in veterans to lower their CVD risk and were open to implementing EBP to enhance HTN management. PICOT: The PICOT question that guided this project was: In the primary care setting, in older adults > 65 years with BP > 140/90 (P), does weekly telehealth coaching (I) compared to no telehealth coaching (C), decrease their BP (O) over a 6-week period (T)? Evidence: The evidence that guided this project was synthesized from eight scholarly articles that show weekly telehealth coaching to be an effective intervention in decreasing BP in the elderly. Intervention: The Telehealth Coaching Intervention (TCI) consisted of receiving a call from RNTC who followed the supervisory checklist for making the telehealth calls. The RNTC instructed the patients about lifestyle management, medication adherence, and self-management of their BP. Outcome: The primary outcome of the DNP project is achieving a BP lower than that measured on enrollment in week “0” and is compared with post-TCI data obtained in week 2, week 4, and week 6. The result of the two-tailed paired samples t-test was significant based on an alpha value of 0.05, t(8) = 8.92, p < .001, showing a significant difference between week “0” and week “6”. Conclusion: This DNP project implemented TCI, an EBP change in older adults > 65 years of age with high BP > 140/90 in the primary care setting, and evaluated the effectiveness of the intervention in a 6-week period. The results show that the goal of the TCI was met in improving patients’ BP within a 6-week period.