Using nurses for preventive activities with computer assisted follow up: a randomised controlled trial.
OBJECTIVE
To assess whether an organised programme of prevention including the use of a health promotion nurse noticeably improved recording and follow up of cardiovascular risk factors and cervical smears in a general practice that had access to computerised cell and recall.


METHODS
Randomised controlled trial.


METHODS
General practice in inner London.


METHODS
All 3206 men and women aged 30-64 registered with the practice.


METHODS
The intervention group had their risk factors ascertained and followed up by the health promotion nurse and the general practitioner, whereas those in the control group were managed by the general practitioner alone.


METHODS
Recording and follow up of blood pressure and cervical smears after three years. Recording of smoking, family history of ischaemic heart disease, and serum cholesterol concentrations were also examined.


RESULTS
When the trial was stopped after two years the measurements of blood pressure in the preceding five years were 93% (1511/1620) v 73% (1160/1586) (95% confidence interval for difference 17.5 to 22.7%) for intervention and control groups respectively. For patients with hypertension the figures were 97% (104/107) v 69% (80/116) (18.2 to 38.2%). For women the proportion who had had a cervical smear in the preceding three years were 76% (606/799) v 49% (392/806) (22.5 to 31.9%). Recording of smoking, family history of ischaemic heart disease, and serum cholesterol concentrations was also higher in the intervention group compared with the control group.


CONCLUSIONS
An organised programme, which includes a nurse with specific responsibility for adult prevention, is likely to make an important contribution to recording of risk factors and follow up of those patients with known risks.
Robson
J
J
Chrisp Street Health Centre, London.
Boomla
K
K
Fitzpatrick
S
S
Jewell
A J
AJ
Taylor
J
J
Self
J
J
Colyer
M
M
D000328:Adult; D001794:Blood Pressure; D002986:Clinical Trials as Topic; D003152:Community Health Nursing; D003199:Computer Systems; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D008131:London; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000379:methods*; D011897:Random Allocation; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014626:Vaginal Smears