Improving Efficiency of the Barbershop Model of Hypertension Care for Black Men With Virtual Visits.
Improving Efficiency of the Barbershop Model of Hypertension Care for Black Men With Virtual Visits.
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DOI：
10.1161/jaha.120.020796
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发表时间：
2021-07-06
影响因子：
5.4
通讯作者：
Rader F
中科院分区：
文献类型：
--
作者：
Blyler CA;Ebinger J;Rashid M;Moy NP;Cheng S;Albert CM;Rader F
LABBPS（洛杉矶理发店血压研究）为非西班牙裔黑人男性开发了一种新的高血压护理模式，将理发师的健康促进与药剂师的药物管理联系起来。扩展该模型的障碍包括导致干预成本的低效率，最明显的是药剂师旅行时间。为了解决这个问题，我们测试了在血压（BP）控制后，虚拟访视是否可以取代面对面访视。我们招募了10名收缩压≥140 mm Hg的黑人男性顾客参加一项概念验证研究，在该研究中，理发师促进了与最初在理发店遇到每位顾客的药剂师的随访，他们根据与顾客医生的合作实践协议处方BP药物。在每两个月一次的亲自访视期间滴定药物，以实现BP ≤130/80 mm Hg的目标。一旦达到BP目标，通过视频会议进行访视。在12个月时评估最终BP和安全性结局。9名患者完成了干预。基线BP为155±14/83.9±11 mm Hg，降低了−28.7±13/−8.9±15 mm Hg（P<0.0001）。这些数据与既往LABBPS数据在统计学上无法区分（收缩压和舒张压变化P=0.8）。高血压控制（≤130/80 mm Hg）为67%（6/9），在数值上大于LABBPS中观察到的63%（P=不显著）。按照预期，12个月内，平均亲自访视次数从LABBPS的11次减少至6.6次。未发生治疗相关严重不良事件。虚拟访问代表了一个可行的替代亲自访问，既提高药剂师的效率和降低成本，同时保持干预效力。URL：https://www.clinicaltrials.gov;唯一标识符：NCT 03726710。
The LABBPS (Los Angeles Barbershop Blood Pressure Study) developed a new model of hypertension care for non‐Hispanic Black men that links health promotion by barbers to medication management by pharmacists. Barriers to scaling the model include inefficiencies that contribute to the cost of the intervention, most notably, pharmacist travel time. To address this, we tested whether virtual visits could be substituted for in‐person visits after blood pressure (BP) control was achieved. We enrolled 10 Black male patrons with systolic BP ≥140 mm Hg into a proof‐of‐concept study in which barbers promoted follow‐up with pharmacists who initially met each patron in the barbershop, where they prescribed BP medication under a collaborative practice agreement with the patrons' physician. Medications were titrated during bimonthly in‐person visits to achieve a BP goal of ≤130/80 mm Hg. Once BP goal was reached, visits were done by videoconference. Final BP and safety outcomes were assessed at 12 months. Nine patients completed the intervention. Baseline BP of 155±14/83.9±11 mm Hg decreased by −28.7±13/−8.9±15 mm Hg (P<0.0001). These data are statistically indistinguishable from prior LABBPS data (P=0.8 for change in systolic BP and diastolic BP). Hypertension control (≤130/80 mm Hg) was 67% (6 of 9), numerically greater than the 63% observed in LABBPS (P=not significant). As intended, the mean number of in‐person visits decreased from 11 in LABBPS to 6.6 visits over 12 months. No treatment‐related serious adverse events occurred. Virtual visits represent a viable substitute for in‐person visits, both improving pharmacist efficiency and reducing cost while preserving intervention potency. URL: https://www.clinicaltrials.gov; Unique identifier: NCT 03726710.