Team-Based Hypertension Management to Improve Blood Pressure Control
Team-Based Hypertension Management to Improve Blood Pressure Control
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DOI：
10.1177/2150131916645580
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发表时间：
2016-10-01
影响因子：
3.6
通讯作者：
Walsh, Robert F.
中科院分区：
文献类型：
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作者：
Kravetz, Jeffrey D.;Walsh, Robert F.
目的：高血压是初级保健中最常见的疾病，在美国每3个成年人中就有1人患有高血压。以患者为中心的医疗之家为高血压提供了积极的、以团队为基础的护理机会。这项先导性研究的目的是在繁忙的初级保健环境中衡量以团队为基础的血压管理方法的有效性。方法：在两个初级保健诊所内采用小组管理，确定了一组血压为160/100 mm Hg的患者。初级保健团队联系了1个诊所的患者，并提供了旨在改善血压控制的多种干预措施；包括讨论服药依从性、药物滴定、家庭血压监测、营养咨询和激励性访谈。将这些患者在4个月时的血压变化与同一医疗中心内的平行初级保健诊所进行比较，后者的患者接受常规初级保健治疗。结果：共有350名患者进入干预组，315名患者纳入常规护理队列。4个月时干预组的收缩压下降幅度明显大于常规护理组(15.6vs9.9 mm Hg；P
Objective: Hypertension is the most common condition seen in primary care, occurring in 1 in 3 adults in the United States. The patient-centered medical home provides an opportunity for proactive, team-based care of hypertension. The purpose of this pilot study was to measure the effectiveness of a team-based approach to blood pressure management in a busy, primary care setting. Methods: Using panel management within 2 primary care clinics, a cohort of patients with blood pressures >160/100 mm Hg, was identified. The patients at 1 clinic were contacted by the primary care team and offered multiple interventions aimed at improving blood pressure control; including discussion of medication compliance, medication titration, home blood pressure monitoring, nutritional counseling, and motivational interviewing. The change in blood pressure for these patients at 4 months was compared to a parallel primary care clinic within the same medical center whose patients were treated with usual primary care. Results: A total of 350 and 315 patients were included in the intervention and usual care cohorts, respectively. At 4 months, the decrease of systolic blood pressure in the intervention group was significantly greater than in the usual care group (15.6 vs 9.9 mm Hg; P