Cluster-randomized controlled trial for the early promotion of clinic visits for untreated hypertension
Cluster-randomized controlled trial for the early promotion of clinic visits for untreated hypertension
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用于早期促进未经治疗的高血压就诊的整群随机对照试验
DOI：
10.1038/s41440-020-00559-0
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发表时间：
2020
影响因子：
5.4
通讯作者：
Miyamatsu N.
中科院分区：
文献类型：
--
作者：
1.Shima A;Arima H;Miura K;Tatsumi Y;Ohkubo T;Kawatsu T;Morino A;Kimura T;Godai K;Azuma S;Miyamatsu N.
尽管有明确的证据表明降低高血压患者的血压有好处，但全球范围内的治疗率仍然低于 40%。在本试验中，我们的目的是调查在年度健康检查中发现的未经治疗的高血压患者中早期促进就诊的效果。这是一项基于工作场所、平行分组、整群随机试验，并进行盲法结果评估。日本152家超市门店的员工在体检时发现患有高血压（血压水平≥160/100 mmHg）且未经治疗，按照随机分配的方式被分配到早期推广组（鼓励去诊所进行面对面访谈，并提供医生推荐信和传单）或对照组（接受常规护理）。主要结果是在 6 个月内完成门诊就诊。使用具有集群随机效应的多级逻辑回归估计早期促销组与对照组的优势比（置信区间为 95%）。来自 107 家商店的总共 273 名参与者（平均年龄 50.3 岁，55% 为女性）被分配到早期促销组（55 家商店中的 138 名）或对照组（52 家商店中的 135 名）。在为期 6 个月的随访期间，早期推广组有 47 名参与者 (34.1%) 前往诊所就诊，对照组有 26 名参与者 (19.3%) 就诊（比值比 2.33，95% 置信区间 1.12-4.84，P=0.024）。在健康检查期间使用转介信进行早期促销显着增加了未经治疗的高血压参与者在 6 个月内完成的就诊次数 (UMIN000025411)。
Despite clear evidence of the benefits of lowering blood pressure among patients with hypertension, the treatment rate remains< 40% worldwide. In the present trial, we aimed to investigate the effects of the early promotion of clinic visits among patients with untreated hypertension detected during annual health checkups. This was a worksite-based, parallel group, cluster-randomized trial with blinded outcome assessment. Employees of 152 Japanese supermarket stores found to have untreated hypertension (blood pressure levels≥ 160/100 mmHg) during health checkups were assigned to an early promotion group (encouraged to visit a clinic in face-to-face interviews and provided with a referral letter to a physician as well as a leaflet) or a control group (received usual care), according to random assignment. The primary outcome was the completion of a clinic visit within 6 months. Odds ratios with 95% confidence intervals for the early promotion group versus the control group were estimated using multilevel logistic regression with random effects of clusters. A total of 273 participants (mean age 50.3 years, 55% women) from 107 stores were assigned to the early promotion group (138 from 55 stores) or control group (135 from 52 stores). During the 6-month follow-up, 47 (34.1%) participants in the early promotion group visited a clinic, as did 26 (19.3%) in the control group (odds ratio 2.33, 95% confidence interval 1.12-4.84, P= 0.024). Early promotion using a referral letter during health checkups significantly increased the number of clinic visits within 6 months completed by participants with untreated hypertension (UMIN000025411).
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影响因子：
--
作者：
R. Velez;L. Anderson;S. Mcfall;K. Magruder
通讯作者：
K. Magruder
影响因子：
2.7
作者：
Jokisalo, E;Kumpusalo, E;Takala, J
通讯作者：
Takala, J
影响因子：
12.3
作者：
Hozawa, Atsushi;Kuriyama, Shinichi;Tsuji, Ichiro
通讯作者：
Tsuji, Ichiro
日本职业健康服务中心面临的挑战。
影响因子：
2
作者：
Y. Hino;H. Kan;Makiko Minami;M. Takada;N. Shimokubo;Tomoaki Nagata;Masako Kurita;K. Uchida;K. Mori
通讯作者：
K. Mori
[日本数据]。
DOI：
--
发表时间：
2006
期刊：
Nihon rinsho. Japanese journal of clinical medicine
影响因子：
--
作者：
Hirotsugu Ueshima
通讯作者：
Hirotsugu Ueshima