Determining the Effect of a Care Bundle for Hypertension Control on the Health Outcomes of Hypertensive Patients with Stroke Risk

Background: Care bundles contain three to five evidence-informed practices, which need to be delivered collectively and consistently to improve health outcomes of patients. Objectives: this study aimed to assess the level of stroke risk among hypertensive patients, evaluate the effect of a care bundle regarding hypertension control on health outcomes of hypertensive patients with stroke risk and identify factors associated with the effect of care bundles on hypertensive patients. Design: a quasi-experimental research design was used in this study. Setting: this study was conducted in medical outpatient clinics of governmental and health insurance hospitals in Port-Said city. Sample: a purposive sample of 105 patients was included. Instruments: three tools were used for data collection, including a structured interview to assess the socio-demographic characteristics and medical histories of patients, a stroke risk assessment screening tool to determine stroke risk among hypertensive patients and clinical measures such as pulse, blood pressure, body mass index, serum cholesterol and fasting blood sugar. Results: the study results revealed obvious improvements in health outcomes of patients, which were reflected in the significant differences in clinical measures, such as systolic blood pressure, cholesterol level, body mass index and fasting blood sugar, with P-values of 0.000, 0.000, 0.000 and 0.002, respectively, between hypertensive patients pre- and three months post-patient education with the care bundle for hypertension control. However, nearly two-thirds of hypertensive patients in the study sample were at moderate risk for stroke, and the rest were at severe risk. Conclusion: the current study concluded that educating hypertensive patients at risk for stroke with the care bundle for hypertension control could significantly improve their clinical measures. The care bundle involves a combination of interrelated evidence-based guidelines, including one guideline that affects another guideline, e.g., appropriate diets for hypertensive patients lead to weight reduction and facilitate physical activity. However, further research on a larger sample that includes hypertensive patients with or without stroke risk is recommended.