Culturally adapted hypertension education (CAHE) to improve blood pressure control and treatment adherence in patients of African origin with uncontrolled hypertension: cluster-randomized trial.
Culturally adapted hypertension education (CAHE) to improve blood pressure control and treatment adherence in patients of African origin with uncontrolled hypertension: cluster-randomized trial.
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DOI：
10.1371/journal.pone.0090103
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Haafkens JA
中科院分区：
文献类型：
--
作者：
Beune EJ;Moll van Charante EP;Beem L;Mohrs J;Agyemang CO;Ogedegbe G;Haafkens JA
评估基于实践的、文化上适当的患者教育干预对非洲裔高血压患者血压（BP）和治疗依从性的影响。一项涉及4家荷兰初级保健中心和146名患者（干预组n = 75，对照组n = 71）的随机分组试验，这些患者符合以下入选标准：自我认定的缅甸人或加纳人;年龄≥20岁;接受高血压治疗; SBP≥140 mmHg。 所有患者均接受常规高血压护理。干预组还提供了三个护士领导的，文化上适当的高血压教育会议。使用Omron 705-IT评估血压，使用生活方式和药物依从性量表评估治疗依从性。139例患者（95%）完成了研究（干预组n = 71，对照组n = 68）。 两组的基线特征基本相似。在6个月时，我们观察到干预组48%和对照组43%的SBP降低≥10 mmHg（主要结局）。当校正预先指定的协变量年龄、性别、高血压病程、教育、基线测量和聚集效应时，组间差异不显著（OR; 0.42; 95%CI：0.11 - 1.54; P = 0.19）。 6个月时，干预组的平均SBP/DBD下降了10/5.7（SD 14.3/9.2）mmHg，对照组下降了6.3/1.7（SD 13.4/8.6）mmHg。调整后，SBP和DBP降低的组间差异分别为-1.69 mmHg（95% CI：-6.01至2.62，P = 0.44）和-3.01 mmHg（-5.73至0.30，P = 0.03），有利于干预组。 干预组的生活方式建议的平均得分增加，但在对照组下降。两组的平均药物依从性评分均略有改善。调整后，坚持生活方式建议的组间差异为0.34（0.12至0.55; P = 0.003）。 药物依从性为-0.09（-0.65至0.46; P = 0.74）。 这种干预导致DBP显著改善，并坚持生活方式的建议，支持文化上适当的高血压护理的需要。Controlled-Trials.com www.example.com
To evaluate the effect of a practice-based, culturally appropriate patient education intervention on blood pressure (BP) and treatment adherence among patients of African origin with uncontrolled hypertension. Cluster randomised trial involving four Dutch primary care centres and 146 patients (intervention n = 75, control n = 71), who met the following inclusion criteria: self-identified Surinamese or Ghanaian; ≥20 years; treated for hypertension; SBP≥140 mmHg. All patients received usual hypertension care. The intervention-group was also offered three nurse-led, culturally appropriate hypertension education sessions. BP was assessed with Omron 705-IT and treatment adherence with lifestyle- and medication adherence scales. 139 patients (95%) completed the study (intervention n = 71, control n = 68). Baseline characteristics were largely similar for both groups. At six months, we observed a SBP reduction of ≥10 mmHg -primary outcome- in 48% of the intervention group and 43% of the control group. When adjusted for pre-specified covariates age, sex, hypertension duration, education, baseline measurement and clustering effect, the between-group difference was not significant (OR; 0.42; 95% CI: 0.11 to 1.54; P = 0.19). At six months, the mean SBP/DBD had dropped by 10/5.7 (SD 14.3/9.2)mmHg in the intervention group and by 6.3/1.7 (SD 13.4/8.6)mmHg in the control group. After adjustment, between-group differences in SBP and DBP reduction were −1.69 mmHg (95% CI: −6.01 to 2.62, P = 0.44) and −3.01 mmHg (−5.73 to −0.30, P = 0.03) in favour of the intervention group. Mean scores for adherence to lifestyle recommendations increased in the intervention group, but decreased in the control group. Mean medication adherence scores improved slightly in both groups. After adjustment, the between-group difference for adherence to lifestyle recommendations was 0.34 (0.12 to 0.55; P = 0.003). For medication adherence it was −0.09 (−0.65 to 0.46; P = 0.74). This intervention led to significant improvements in DBP and adherence to lifestyle recommendations, supporting the need for culturally appropriate hypertension care. Controlled-Trials.com ISRCTN35675524
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影响因子：
5.9
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