Implementing a home-based virtual hypertension programme-a pilot feasibility study.
Implementing a home-based virtual hypertension programme-a pilot feasibility study.
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DOI：
10.1093/fampra/cmac084
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发表时间：
2023-03-28
期刊：
影响因子：
2.2
通讯作者：
中科院分区：
文献类型：
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实施以卫生系统为基础的高血压规划可以降低血压。我们进行了一项随机、对照的试点研究，以评估基于家庭的虚拟高血压计划的可行性、可接受性和安全性，该计划整合了基于证据的策略，以克服当前血压控制的障碍。训练有素的临床药剂师为虚拟协同护理诊所（vCCC）配备人员，使用血压仪表板和电话“访问”来监测血压、依从性、药物的副作用，并开具抗高血压药物。通过电子健康记录确定不受控制的高血压患者。入组患者随机分为vCCC组和常规治疗组，为期3个月。我们评估了患者的家庭血压监测行为，以及患者、医生和药剂师对个别方案组成部分的可行性和可接受性的看法。来自6个医生诊所的31名患者（vCCC = 17，常规护理= 14）完成了初步研究。3个月后，vCCC组的平均血压下降（P = 0.01），而对照组没有下降（P = 0.45）。vCCC组的血压测量值更高（9.9 vs 1.2 /周，P < 0.001）。没有干预相关的不良事件。参与研究的医生（n = 6）、药剂师（n = 5）和患者（n = 31）对所有方案组成部分的平均评分为bb0 4.0，这是一个预先设定的基准。根据实施方案的潜在障碍和建议，对vCCC的设计和交付进行了九项调整。以家庭为基础的虚拟高血压规划采用团队护理、技术和循证策略的合理整合，对目标用户来说是安全、可接受和可行的。这些试点数据支持在更大范围内评估该方案有效性的研究。
Implementing a health system-based hypertension programme may lower blood pressure (BP). We performed a randomized, controlled pilot study to assess feasibility, acceptability, and safety of a home-based virtual hypertension programme integrating evidence-based strategies to overcome current barriers to BP control. Trained clinical pharmacists staffed the virtual collaborative care clinic (vCCC) to remotely manage hypertension using a BP dashboard and phone “visits” to monitor BP, adherence, side effects of medications, and prescribe anti-hypertensives. Patients with uncontrolled hypertension were identified via electronic health records. Enrolled patients were randomized to either vCCC or usual care for 3 months. We assessed patients’ home BP monitoring behaviour, and patients’, physicians’, and pharmacists’ perspectives on feasibility and acceptability of individual programme components. Thirty-one patients (vCCC = 17, usual care = 14) from six physician clinics completed the pilot study. After 3 months, average BP decreased in the vCCC arm (P = 0.01), but not in the control arm (P = 0.45). The vCCC participants measured BP more (9.9 vs. 1.2 per week, P < 0.001). There were no intervention-related adverse events. Participating physicians (n = 6), pharmacists (n = 5), and patients (n = 31) rated all programme components with average scores of >4.0, a pre-specified benchmark. Nine adaptations in vCCC design and delivery were made based on potential barriers to implementing the programme and suggestions. A home-based virtual hypertension programme using team-based care, technology, and a logical integration of evidence-based strategies is safe, acceptable, and feasible to intended users. These pilot data support studies to assess the effectiveness of this programme at a larger scale.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
DOI：
10.2215/cjn.08530815
发表时间：
2016-04-01
影响因子：
9.8
作者：
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通讯作者：
Rahman, Mahboob
影响因子：
39
作者：
Drawz, Paul E.;Agarwal, Anil;Pajewski, Nicholas M.
通讯作者：
Pajewski, Nicholas M.
影响因子：
39.2
作者：
Brehaut, Jamie C.;Colquhoun, Heather L.;Grimshaw, Jeremy M.
通讯作者：
Grimshaw, Jeremy M.
影响因子：
120.7
作者：
Green, Beverly B.;Cook, Andrea J.;Thompson, Robert S.
通讯作者：
Thompson, Robert S.