title: Pilot trial of a licensed practical nurse intervention for hypertension and depression.
abstract: OBJECTIVE
  Depression is a risk factor for hypertension, and risk of depression is increased substantially in patients with hypertension. Our objective was to examine whether an intervention carried out by Licensed Practical Nurses (LPNs) integrating depression treatment into care for hypertension improved blood pressure control and depressive symptoms.
  
  
  METHODS
  In all, 60 patients ages 41 to 92 years with hypertension and depressive symptoms at a large primary care practice in Philadelphia were randomly assigned to an integrated care intervention carried out by LPNs (n=30) or usual care (n=30). Intervention and control groups did not differ statistically on baseline measures. Outcomes assessed at baseline and 12 weeks included standard laboratory procedures to measure blood pressure control and the Patient Health Questionnaire (PHQ-9) to assess depression.
  
  
  RESULTS
  Patients in the integrated care intervention had lower diastolic blood pressure (intervention 74.2 mmHg versus usual care 82.0 mmHg) and fewer depressive symptoms (PHQ-9 mean scores, intervention 2.4 versus usual care 7.1) compared with patients in the usual care group at 12 weeks after adjustment for baseline values. Patients in the integrated care intervention also had lower systolic blood pressure (intervention 130.0 mmHg versus usual care 140.6 mmHg) compared with patients in the usual care group at 12 weeks although the results approached but did not reach conventional levels of statistical significance.
  
  
  CONCLUSIONS
  Training existing primary care practice office staff will facilitate implementation in real world practices with limited resources and competing demands.
authors.affiliation: Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA. hillary.bogner@uphs.upenn.edu
authors.forename: Hillary R
authors.initials: HR
authors.lastname: Bogner
authors.forename: Heather F
authors.initials: HF
authors.lastname: de Vries
authors.forename: Elise M
authors.initials: EM
authors.lastname: Kaye
authors.forename: Knashawn H
authors.initials: KH
authors.lastname: Morales
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D003863:Depression / Q000150:complications / Q000451:nursing* / Q000517:prevention & control; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000451:nursing* / Q000517:prevention & control; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010865:Pilot Projects; D057184:Practice Patterns, Nurses'; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome