Electronic Communications and Home Blood Pressure Monitoring (e-BP) study: Design, delivery, and evaluation framework
Electronic Communications and Home Blood Pressure Monitoring (e-BP) study: Design, delivery, and evaluation framework
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DOI：
10.1016/j.cct.2007.09.005
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发表时间：
2008-05-01
影响因子：
2.2
通讯作者：
Thompson, Robert S.
中科院分区：
文献类型：
--
作者：
Green, Beverly B.;Ralston, James D.;Thompson, Robert S.
背景资料：随机对照试验提供了明确的证据表明，高血压的治疗降低了心血管疾病的死亡率和主要残疾;然而，在大多数受影响的个体中，血压仍然没有得到充分的治疗。尽管超过90%的高血压成年人拥有医疗保险，而且高血压是就诊的主要原因，但这一巨大差距仍在继续。需要新的方法来改善高血压护理。目的：电子通信和家庭血压监测（e-BP）研究是一项三臂随机对照试验，旨在确定是否基于慢性护理模式和通过互联网提供的护理改善高血压护理。主要研究结果是收缩压，舒张压和血压控制;次要结果是药物治疗依从性，患者自我效能，满意度和生活质量，医疗保健利用率和costs.Methods：高血压患者接受护理在集团健康医疗中心是合格的，如果他们有不受控制的血压在两个筛选访问和访问网络和电子邮件地址。研究参与者被随机分配到三个干预组：（a）常规护理;（B）家庭血压监测收据及其使用的熟练培训和Group Health secure patient website（通过安全的电子邮件访问他们的医疗保健提供者，访问共享的医疗记录，处方补充和其他服务）;或者（c）这加上药剂师护理管理（经由安全的患者网站和电子医疗记录在患者、药剂师和患者的医生之间的协作护理管理）。结论：我们将确定一个新的模式，以病人为中心的护理，利用网络通信，自我监测和协作护理管理，提高高血压控制。如果这种模式被证明是成功的和具有成本效益的，类似的干预措施可以用来改善大量不受控制的高血压患者的护理。(C)2007年爱思唯尔公司All rights reserved.
Background: Randomized controlled trials have provided unequivocal evidence that treatment of hypertension decreases mortality and major disability from cardiovascular disease; however, blood pressure remains inadequately treated in most affected individuals. This large gap continues despite the facts that more than 90% of adults with hypertension have health insurance, and hypertension is the leading cause of visits to the doctor. New approaches are needed to improve hypertension care.Objectives: The Electronic Communications and Home Blood Pressure Monitoring (e-BP) study is a three-arm randomized controlled trial designed to determine whether care based on the Chronic Care Model and delivered over the Internet improves hypertension care. The primary study outcomes are systolic, diastolic, and blood pressure control; secondary outcomes are medication adherence, patient self-efficacy, satisfaction and quality of life, and healthcare utilization and costs.Methods: Hypertensive patients receiving care at Group Health medical centers are eligible if they have uncontrolled blood pressure on two screening visits and access to the Web and an e-mail address. Study participants are randomly assigned to three intervention groups: (a) usual care; (b) home blood pressure monitoring receipt and proficiency training on its use and the Group Health secure patient website (with secure e-mail access to their healthcare provider, access to a shared medical record, prescription refill and other services); or (c) this plus pharmacist care management (collaborative care management between the patient, the pharmacist, and the patient's physician via a secure patient website and the electronic medical record). Conclusion: We will determine whether a new model of patient-centered care that leverages Web communications, self-monitoring, and collaborative care management improves hypertension control. If this model proves successful and cost-effective, similar interventions could be used to improve the care of large numbers of patients with uncontrolled hypertension. (C) 2007 Elsevier Inc. All rights reserved.