Deterioration of blood pressure control after discontinuation of a physician-pharmacist collaborative intervention.
Deterioration of blood pressure control after discontinuation of a physician-pharmacist collaborative intervention.
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DOI：
10.1592/phco.30.3.228
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发表时间：
2010-03
期刊：
影响因子：
4.1
通讯作者：
Chrischilles EA
中科院分区：
文献类型：
--
作者：
Carter BL;Doucette WR;Franciscus CL;Ardery G;Kluesner KM;Chrischilles EA
评价医生/药剂师协作干预停止后的血压（BP）控制。血压先前在基线和9个月的随机分组干预试验结束时测量。本研究提取了18个月（干预停止后9个月）和27个月（干预停止后18个月）时平均BP和BP控制的病历数据。五个初级保健医疗办公室由大学卫生系统运营。入组既往对照试验并同意在研究结束后额外提取18个月数据的高血压受试者。9个月后，医生/药剂师协作干预以改善血压控制，并评估了血压和干预退出后血压的变化。一名研究护士在9个月的干预性研究期间测量血压。然后从研究结束后18个月的病历中提取BP值。104名患者在所有4个时间段都有血压值。基线时，干预组和对照组的收缩压（SBP）分别为152.5 ± 9.5和150.1 ± 9.6 mm Hg（p=0.22）。9个月时，SBP分别降至124.5 ± 10.7和132.0 ± 15.1 mm Hg（两组间p=0.0038），干预组和对照组的血压控制率分别为78.5%和48.7%（p=0.0017）。到18个月时，干预组和对照组的SBP分别恶化至131.0 ± 12.2和143.3 ± 17.5 mm Hg（p<0.001），BP控制率分别恶化至53.9%和30.8%（p=0.02）。到27个月时，干预组和对照组的收缩压分别为131.3 ± 13.0和141.2 ± 15.8 mm Hg（p=0.0008），血压控制率分别为55.3%和35.9%（p=0.05）。这项研究发现，在停止药剂师干预后，对血压控制的持续影响长达18个月。然而，干预组和对照组的血压控制以相似的速度恶化，但干预组仍显着较高。这项研究表明，药剂师的持续干预可能是必要的，以保持高血压控制率，特别是在那些失去血压控制的患者。
To evaluate blood pressure (BP) control following discontinuation of a physician\pharmacist collaborative intervention. BP was previously measured at baseline and at the end of a 9-month cluster-randomized intervention trial. This study abstracted medical record data for mean BP and BP control at 18 months (9 months after the discontinuation of the intervention) and at 27 months (18 months after discontinuation of the intervention). Five primary care medical offices operated by a university health system. Subjects with hypertension who were enrolled in a previous controlled trial and who consented to have data abstracted for an additional 18 months following the end of that study. A physician\pharmacist collaborative intervention to improve BP control was withdrawn after 9 months and BP and the change in BPs following withdrawal of the intervention were evaluated. A research nurse measured BP during the 9-month interventional study. BP values were then abstracted from the medical record for the 18 month period after the end of that study. 104 patients had BP values at all 4 time periods. At baseline, systolic BP (SBP) was 152.5 ± 9.5 and 150.1 ± 9.6 mm Hg in the intervention and control groups, respectively (p=0.22). At 9 months, SBP decreased to 124.5 ± 10.7 and 132.0 ± 15.1 mm Hg (p=0.0038 between groups) and BP was controlled in 78.5% and 48.7% in the intervention and control groups, respectively (p=0.0017). By 18 months, SBP had deteriorated to 131.0 ± 12.2 and 143.3 ± 17.5 mm Hg (p<0.001) and BP control rates deteriorated to 53.9% and 30.8% in the intervention and control groups, respectively (p=0.02). By 27 months, SBP was 131.3 ± 13.0 and 141.2 ± 15.8 mm Hg (p=0.0008) and BP control was 55.3% and 35.9% in the intervention and control groups, respectively (p=0.05). This study found a sustained effect on BP control up to 18 months following discontinuation of a pharmacist intervention. However, BP control deteriorated at a similar rate in both the intervention and control group but remained significantly higher in the intervention group. This study suggests that continued interventions by pharmacists may be necessary to maintain high rates of BP control, especially in those patients who lose BP control.
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DOI：
10.1001/jama.296.21.joc60162
发表时间：
2006-12-06
影响因子：
120.7
作者：
Lee, Jeannie K.;Grace, Karen A.;Taylor, Allen J.
通讯作者：
Taylor, Allen J.
影响因子：
37.8
作者：
MCKENNEY, JM;SLINING, JM;BARR, M
通讯作者：
BARR, M
影响因子：
4.1
作者：
Vivian, EM
通讯作者：
Vivian, EM
影响因子：
--
作者：
Von Muenster, Shannon J.;Carter, Barry L.;Xu, Yinghui
通讯作者：
Xu, Yinghui
影响因子：
4.1
作者：
Milchak, Jessica L.;Carter, Barry L.;Franciscus, Carrie L.
通讯作者：
Franciscus, Carrie L.