THE ROLE OF NURSE-LED HEALTH EDUCATION IN HYPERTENSION MANAGEMENT: A SCOPING REVIEW OF EXISTING STRATEGIES AND UNADDRESSED GAPS IN KENYA

Abstract

Hypertension remains a major public health concern, particularly in low- and middle-income countries (LMICs) like Kenya, where control rates are suboptimal due to healthcare delivery gaps. Although nurse-led interventions have shown effectiveness in managing chronic diseases globally, their role in hypertension care within Kenya's healthcare system remains underutilized. This scoping review explores the impact of nurse-led health education interventions in hypertension management and identifies gaps in their implementation. A systematic literature search was conducted across major academic databases, including PubMed, Google Scholar, CINAHL, and the WHO Global Health Library, using predefined search terms. Studies examining physician-led, pharmacist-led, community-based, and nurse-led hypertension interventions were analyzed for effectiveness and limitations. Inclusion criteria encompassed peer-reviewed articles, systematic reviews, and government reports published within the last decade. Findings indicate that physician-led models dominate hypertension care in Kenya but often lack structured patient education and adherence support. Pharmacist-led and community-based interventions have demonstrated improvements in medication adherence but remain inadequately integrated into routine care. Nurse-led interventions, which emphasize patient education, lifestyle counseling, and follow-up care, have shown success in other regions but face barriers such as workforce constraints, lack of standardized education programs, and minimal policy integration in Kenya. This review underscores the need for structured nurse-led hypertension education interventions to improve patient adherence and blood pressure control. Key policy recommendations include the development of task-shifting frameworks, specialized nurse training, integration of nurse-led interventions into Universal Health Coverage (UHC) policies, and the implementation of pilot nurse-led hypertension clinics in Level 4 and 5 hospitals. Additionally, mobile health technologies can enhance adherence monitoring and follow-up care. Consideration of gray literature, including government policies and unpublished reports, provided contextual insights but revealed challenges in accessing comprehensive data. The PRISMA diagram illustrates the study selection process, and Appendix C presents a data extraction table summarizing key studies on hypertension management interventions.