Globally, chronic diseases present a burden to many people and healthcare systems. According to the World Health Organization (2019), chronic illnesses have contributed to over 60% of the total global deaths since 2001. Besides, the number is expected to rise exponentially towards the end of 2020. Hypertension, merely referring to high blood pressure, is one chronic disease that has far-reaching health-related complications and risk factors that can lead to stroke, heart disease, or even death. The force exerted against the arteries as blood is pumped to other parts of the body constitute blood pressure (CDC, 2020). When the pressure is higher than usual and persists for extended periods, it can severely impact the heart, leading to other health problems. This paper will examine the population vulnerable to hypertension, compare the current prevalence statistics and its seriousness within that population, assess the need for formal case management and its potential benefits, analyze why nurses should be the frontrunners of case management programs, and identify other members who should make up the multidisciplinary team.
Hypertension and Population Metrics
Hypertension is a preventable chronic noncommunicable disease (NCD) that affects the adult population across the globe. In the United States alone, the CDC (2020) estimates that half of the adult population has hypertension, with only one in four people having their condition under control. With the country having a high aging population and increased life expectancy rate, the prevalence of hypertension will continue to rise. Hypertension`s correlation with other heart diseases poses public health challenge for the country. In most cases, people are unaware of any underlying health conditions, specifically, hypertension, as it does not depict any warning signs or symptom. As such, it is recommended that people measure their blood pressure frequently.
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With current advancements in technology and their incorporation in the health sector, wearable devices are now capable of measuring and tracking blood pressure, notifying the user of any impending danger. However, experts warn that hypertension may take years to develop and eventually affect everyone. Regardless, if symptoms occur, a person may experience headaches, irregular heartbeats, and nose bleeds, among others (WHO, 2019). These symptoms are not person-specific and do not occur unless the individual registers extremely high blood pressure that threatens his health and life.
D iet and nutrition play a significant role in managing one's health and averting the onset of chronic illnesses. Unhealthy diets are one of the modifiable risk elements that contribute to high blood pressure, including foods high in salt and trans-fat (WHO, 2019). Obesity also leads to hypertension. Gaining weight puts more strain on the heart and blood circulatory mechanism. In essence, obesity increases blood pressure, leading to other health concerns, including diabetes and cardiovascular disease. The lack of physical activity can further contribute to high blood pressure. Physical activity is necessary to maintain body weight, burn fats, and improve the functionality of the heart and blood circulatory system. The relationship between physical activity and obesity is relative, and managing both is paramount to a healthy lifestyle.
Stress, tobacco, and alcohol use are other modifiable risk factors associated with high blood pressure. While stress, in itself, is not bad, too much stress can influence behaviors that lead to high blood pressure. More so, engaging in tobacco and alcohol abuse as a result of stress further fuels the onset of hypertension. Consuming excessive alcohol can cause a myriad of other health challenges, including heart failure, irregular heartbeats, and stroke. On the other hand, tobacco can dramatically lead to heart disease and damaged arteries.
For non-modifiable risk factors, family history, other underlying diseases, age, gender, and race are attributed to hypertension. According to Ranasinghe et al. (2015), several studies have shown the correlation between hypertension and family medical history. If aany member of the family had hypertension, then another member will likely have the disease. Age also plays another role. As people age, blood vessels lose their functionality and elasticity, increasing the possibility of high blood pressure. Moreover, WHO (2019) acknowledges that underlying diseases such as kidney disease and diabetes are risk factors of hypertension.
Evaluation of the Population
In the U.S, hypertension is affection a large number of the adult population, indicating its seriousness as a chronic disease in the country. Globally, nearly a third of the adult population already has hypertension, and the chronic disease is the leading cause of cardiovascular-related deaths. Low-income regions have recorded the highest number of hypertension cases compared to developed nations, for instance 27% in Africa compared to 18% in the U.S (WHO, 2019). The risk factors in low-income regions adversely affects the population.
Formal Case Management for Hypertension
The aggressiveness of hypertension mandates patients to take an active role in the treatment process. Patient participation will encompass monitoring and controlling the high blood pressure through therapeutic support from the relevant health professionals (de Fátima Mantovani et al., 2018). As such, the best approach is through case management, which will involve collaboration between nurses and patients in creating and monitoring a care plan. The plan is aimed at achieving set goals and actions that are tailored to the patient's needs. The case management program will provide adequate interventions and resources necessary for the success of the care plan (de Fátima Mantovani et al., 2018).
Potential Benefits of Implementing a Case Management Model
Arguably, health complications among the aging population are putting healthcare systems under increased pressure. The use of case management models has been attributed to cost-effectiveness and coordinated care, improving the quality of care for the patients. According to Stokes et al. (2015), nurse-patient relationships within these models help foster the quality of care prescribed by the care plan, patient satisfaction, and effective communication between nurses, patients, and their families. Economically, the model reduces health costs as it mitigates readmissions. Through the case management model, nurses can also foster health promotion and wellness to the patient and family members (Stokes et al., 2015).
Why Nurses Should Coordinate the Care Plan
Nurses perform a vital function in the provision of care to all patients, and their skills and knowledge are specifically suited to manage patient needs, coordinate health-related processes, assess, monitor, and treat patients from diverse groups. Nurses are trained to coordinate care, focusing on the financial and resource utilization metrics of nursing for effective cost management and patient-centered outcomes. Moreover, nurses understand the challenges healthcare systems present to patients and are quick to enforce patient adherence to the laid-down care plans. Nursing solely focuses on the whole person, a significant aspect of case management, and their training is sufficient to foster a multidisciplinary care approach.
Stakeholders in a Multidisciplinary Case Management Model
Collaboration among different health professionals is critical to the success of a case management model. Teams help the case manager create a comprehensive patient plan that incorporates all aspects of patient-centered care. The multidisciplinary team should comprise of the case manager, patients and their family members, and health professionals from different departments, including nutritionists, psychologists, and social workers. Each team member plays their part to ensure the patient adheres to the care plan, assessment and monitoring are done effectively, and the quality of care is maintained. Coordination and collaboration within the multidisciplinary team will allow the patient to receive all care from a wide range of healthcare services, boosting the overall patient outcome.
Conclusion
Hypertension is slowly killing the aging population across the globe. The chronic illness is attributed to increased cases of cardiovascular disease, stroke, and heart failure. Significant evidence points to unhealthy food consumption, alcohol and tobacco use, age and gender, family history, and stress, among other risk factors, as contributing to elevating levels of blood pressure among the adult population. With long-term care necessary to control hypertension, a case management model is critical to the success of the care plan. Patients and nurses must collaborate to ensure that adherence to the care plan is strictly followed, and the effectiveness of this coordination depends on a multidisciplinary approach focused on providing patient-centered care. In essence, a case management model improves the patient's quality of life, fosters effective communication between nurses and the patients, and minimizes overall healthcare costs.
References
CDC. (2020). Facts about hypertension . Centers for Disease Control and Prevention. https://www.cdc.gov/bloodpressure/facts.htm
de Fátima Mantovani, M., Kalinke, L. P., da Silva, Â. T. M., Arthur, J. P., Radovanovic, C. A. T., & Bortolato-Major, C. (2018). Effectiveness of case management performed by nurses for blood pressure control in adults with hypertension: a systematic review protocol. JBI database of systematic reviews and implementation reports , 16 (9), 1779-1784. doi: 10.11124/JBISRIR-2017-003647
Ranasinghe, P., Cooray, D. N., Jayawardena, R., & Katulanda, P. (2015). The influence of family history of hypertension on disease prevalence and associated metabolic risk factors among Sri Lankan adults. BMC public health , 15 (1), 576. DOI: 10.1186/s12889-015-1927-7
Stokes, J., Panagioti, M., Alam, R., Checkland, K., Cheraghi-Sohi, S., & Bower, P. (2015). Effectiveness of Case Management for 'At Risk' Patients in Primary Care: A Systematic Review and Meta-Analysis. PloS one , 10 (7), e0132340. https://doi.org/10.1371/journal.pone.0132340
WHO. (2019). Hypertension . WHO | World Health Organization. https://www.who.int/news-room/fact-sheets/detail/hypertension
