5-YEAR BLOOD-PRESSURE CONTROL AND MORTALITY FOLLOWING HEALTH-EDUCATION FOR HYPERTENSIVE PATIENTS
5-YEAR BLOOD-PRESSURE CONTROL AND MORTALITY FOLLOWING HEALTH-EDUCATION FOR HYPERTENSIVE PATIENTS
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DOI：
10.2105/ajph.73.2.153
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发表时间：
1983-01-01
影响因子：
12.7
通讯作者：
SMITH, CR
中科院分区：
文献类型：
--
作者：
MORISKY, DE;LEVINE, DM;SMITH, CR
采用随机析因设计，对城市贫困高血压患者依次进行3种健康教育干预措施：离职面谈，以增加对处方方案的理解和依从性;家访，以鼓励家人为患者的方案提供支持;邀请小组会议，以增加患者的信心和管理自己问题的能力。先前对最初2年经验的评估表明，教育计划对药物治疗和血压控制的依从性有积极影响。现在提供额外3年的累积数据，包括死亡率分析。研究组由8个实验组和对照组的400名门诊动态高血压患者组成。5年的分析表明，持续的积极影响，约会保持，体重控制和血压控制。实验组全因死亡率比对照组低57.3%（12.9/100 vs.30.2/100，P < 0.05），高血压相关死亡率比对照组低53.2%（8.9/100 vs.19.0/100，P < 0.01）。这项纵向研究的结果提供了证据，鼓励卫生从业人员在长期管理和控制高血压中利用这些教育计划。
Three health education interventions for urban poor hypertensive patients were introduced sequentially in a randomized factorial design: an exit interview to increase understanding of and compliance with the prescribed regimen; a home visit to encourage a family member to provide support for the patient''s regimen; and invitations to small group sessions to increase the patient''s confidence and ability to manage his/her problem. Previous evaluation of the initial 2 yr experience demonstrated a positive effect of the educational program on compliance with the medical treatment and blood pressure control. Data accumulated over an additional 3 yr, including mortality analysis, are now presented. The study group consisted of the same cohort of 400 ambulatory hypertensive outpatients in the 8 experimental and control groups. The 5 yr analysis shows a continuing positive effect on appointment keeping, weight control, and blood pressure control. All-cause life table mortality rate was 57.3% less for the experimental group compared to the control group (12.9/100 vs. 30.2/100, P < 0.05), while the hypertension-related mortality rate was 53.2% less (8.9/100 vs. 19.0/100, P < 0.01). The results from this longitudinal study provide evidence to encourage health practitioners to utilize such educational programs in the long-term management and control of high blood pressure.