Linking community-based blood pressure measurement to clinical care: A randomized controlled trial of outreach and tracking by community health workers
Linking community-based blood pressure measurement to clinical care: A randomized controlled trial of outreach and tracking by community health workers
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DOI：
10.2105/ajph.89.6.856
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发表时间：
1999-06-01
影响因子：
12.7
通讯作者：
Martin, D
中科院分区：
文献类型：
--
作者：
Krieger, J;Collier, C;Martin, D
目标。本研究评估了社区卫生工作者加强跟踪和随访服务在促进对城市社区血压测量中发现血压升高的人员进行医疗随访方面的有效性。方法。在一项随机对照试验中，421 名参与者接受了加强转诊或常规转诊治疗。参与者年满 18 岁；是黑人或白人，血压高于或等于 140/90 mm 无花果，收入等于或低于贫困线的 200%。主要结局指标是转诊后 90 天内完成医疗随访。结果。与平常相比，强化干预使随访率增加了 39.4%（95% 置信区间 [CI] = 14%、71%；P = .001）。干预组中有 65.1% 的参与者完成了后续随访，而常规护理组的这一比例为 46.7%。每次额外的随访需要治疗 5 名患者 (95% CI = 3, 13)。结论。加强跟踪和外展活动增加了社区测量期间发现的血压升高并接受医疗护理的人数比例。
Objectives. This study assessed the effectiveness of enhanced tracking and follow-up services provided by community health workers in promoting medical follow-up of persons whose elevated blood pressures were detected during blood pressure measurement at urban community sites.Methods. In a randomized controlled trial, 421 participants received either enhanced or usual referrals to care. Participants were 18 years or older; were either Black or White, and had blood pressure greater than or equal to 140/90 mm fig and income equal to or less than 200% of poverty. The primary outcome measure was completion of a medical follow-up visit within 90 days of referral.Results. The enhanced intervention increased follow-up by 39.4% (95% confidence interval [CI] = 14%, 71%; P = .001) relative to usual can. Follow-tap visits were completed by 65.1% of participants in the intervention group, compared with 46.7% of those in the usual-care group. The number needed to treat was 5 clients (95% CI = 3, 13) per additional follow-up visit realized.Conclusions. Enhanced tracking and outreach increased the proportion of persons with elevated blood pressure-detected during community measurement who followed up with medical care.