Home-based interventions for black patients with uncontrolled hypertension: a cluster randomized controlled trial.

Home-based interventions for black patients with uncontrolled hypertension: a cluster randomized controlled trial.
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DOI:
10.2217/cer.15.60
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发表时间:
2016-03
影响因子:
2.1
通讯作者:
P. Feldman;M. McDonald;Y. Barrón;L. Gerber;T. Peng
P. Feldman;M. McDonald;Y. Barrón;L. Gerber;T. Peng
中科院分区:
医学4区
文献类型:
--
作者:
P. Feldman;M. McDonald;Y. Barrón;L. Gerber;T. Peng

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AIM Assess the comparative effectiveness of two blood pressure (BP) control interventions for black patients with uncontrolled hypertension. PATIENTS & METHODS A total of 845 patients were enrolled in a three-arm cluster randomized trial. On admission of an eligible patient, field nurses were randomized to usual care, a basic or augmented intervention. RESULTS Across study arms there were no significant 12 months differences in BP control rates (primary outcome) (25% usual care, 26% basic intervention, 22% augmented intervention); systolic BP (143.8 millimeters of mercury [mmHg], 146.9 mmHG, 143.9 mmHG, respectively); medication intensification (47, 43, 54%, respectively); or self-management score (18.7, 18.7, 17.9, respectively). Adjusted systolic BP dropped more than 10 mmHg from baseline to 12 months (155.5-145.4 mmHg) among all study participants. CONCLUSION Neither the augmented nor basic intervention was more effective than usual care in improving BP control, systolic BP, medication intensification or patient self-management. Usual home care yielded substantial improvements, creating a high comparative effectiveness threshold. CLINICAL TRIAL REGISTRATION NCT00139490.