Effect of Nurse-Based Management of Hypertension in Rural Western Kenya.
Effect of Nurse-Based Management of Hypertension in Rural Western Kenya.
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DOI：
10.5334/gh.856
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发表时间：
2020-12-01
期刊：
影响因子：
3.7
通讯作者：
Kimaiyo S
中科院分区：
文献类型：
--
作者：
Vedanthan R;Kumar A;Kamano JH;Chang H;Raymond S;Too K;Tulienge D;Wambui C;Bagiella E;Fuster V;Kimaiyo S
高血压是全球死亡的主要原因;然而，治疗和控制率仍然很低。越来越多的文献支持将高血压护理任务重新分配给护士的策略。我们的目的是评估在肯尼亚的护士为基础的高血压管理计划的效果。我们对2011年1月1日至2013年10月31日期间开始以护士为基础的高血压管理护理的高血压患者进行了回顾性数据分析。主要结果测量是收缩压（SBP）在一年内的变化，使用分段线性混合效应模型进行分析，临界点为3个月。主要比较的兴趣是护士与临床人员提供的护理。次要结果是一年内舒张压（DBP）的变化，以及使用零膨胀泊松模型分析的血压控制。该队列包括1051例成人患者（平均年龄61岁; 65%为女性）。SBP从基线至3个月显著降低（护士管理的患者：斜率-4.95 mmHg/月;临床官员管理的患者：斜率-5.28），组间无显著差异。DBP也从基线到三个月显著下降，提供者组之间没有差异。12个月时的护理保留率为42%。护士管理的高血压护理可以显着改善血压。然而，保持护理仍然是一个挑战。如果这些结果在前瞻性试验中重现，并改善护理保留，这可能是全球高血压护理的有效策略。
Elevated blood pressure is the leading cause of death worldwide; however, treatment and control rates remain very low. An expanding literature supports the strategy of task redistribution of hypertension care to nurses. We aimed to evaluate the effect of a nurse-based hypertension management program in Kenya. We conducted a retrospective data analysis of patients with hypertension who initiated nurse-based hypertension management care between January 1, 2011, and October 31, 2013. The primary outcome measure was change in systolic blood pressure (SBP) over one year, analyzed using piecewise linear mixed-effect models with a cut point at 3 months. The primary comparison of interest was care provided by nurses versus clinical officers. Secondary outcomes were change in diastolic blood pressure (DBP) over one year, and blood pressure control analyzed using a zero-inflated Poisson model. The cohort consisted of 1051 adult patients (mean age 61 years; 65% women). SBP decreased significantly from baseline to three months (nurse-managed patients: slope –4.95 mmHg/month; clinical officer-managed patients: slope –5.28), with no significant difference between groups. DBP also significantly decreased from baseline to three months with no difference between provider groups. Retention in care at 12 months was 42%. Nurse-managed hypertension care can significantly improve blood pressure. However, retention in care remains a challenge. If these results are reproduced in prospective trial settings with improvements in retention in care, this could be an effective strategy for hypertension care worldwide.
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影响因子：
15.8
作者：
Ogedegbe G;Plange-Rhule J;Gyamfi J;Chaplin W;Ntim M;Apusiga K;Iwelunmor J;Awudzi KY;Quakyi KN;Mogaverro J;Khurshid K;Tayo B;Cooper R
通讯作者：
Cooper R
DOI：
10.1016/s0140-6736(18)32225-6
发表时间：
2018-11-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2017 Risk Factor Collaborators
通讯作者：
GBD 2017 Risk Factor Collaborators
影响因子：
2.8
作者：
Kengne, Andre P.;Awah, Paschal K.;Mbanya, Jean-Claude
通讯作者：
Mbanya, Jean-Claude
影响因子：
3.3
作者：
Labhardt, Niklaus D.;Balo, Jean-Richard;Stoll, Beat
通讯作者：
Stoll, Beat
影响因子：
4.9
作者：
van de Vijver, Steven J. M.;Oti, Samuel O.;Kyobutungi, Catherine
通讯作者：
Kyobutungi, Catherine