Hypertension outcomes through blood pressure monitoring and evaluation by pharmacists (HOME study)
Hypertension outcomes through blood pressure monitoring and evaluation by pharmacists (HOME study)
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DOI：
10.1111/j.1525-1497.2005.0226.x
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发表时间：
2005-12-01
影响因子：
5.7
通讯作者：
Carter, BL
中科院分区：
文献类型：
--
作者：
Zillich, AJ;Sutherland, JM;Carter, BL
目的：评估基于社区药剂师的家庭血压 (BP) 监测计划的有效性。设计：在 12 个社区药房随机进行高强度 (HI) 与低强度 (LI) 干预试验。 HI 干预包括与训练有素的药剂师进行 4 次面对面访问。药剂师为患者提供有关高血压的针对性教育。在第一次和第三次就诊后，为患者提供了家用血压监测设备，并指示患者在下个月至少每天测量一次血压。药剂师使用家庭血压读数为患者的医生制定治疗建议。与医生讨论建议，如果获得批准，则由药剂师实施。在 LI 干预中，药剂师在药房测量患者血压，并将他们转介给医生进行评估。参与者：基线时血压未受控制的患者。测量：主要结果是 HI 和 LI 患者从基线到随访期间收缩压和舒张压（SBP 和 DBP）的差异。结果：该研究纳入了 125 名患者，其中 64 名属于 HI 组，61 名属于 LI 组。 HI 组收缩压较基线下降 13.4 mmHg，LI 组收缩压较基线下降 9.0 mmHg。最后一次访视时，HI 组和 LI 组之间的 SBP/DBP 变化差异为 -4.5/-3.2 mmHg（SBP P=.12，DBP P=.03）。结论：HI 干预实现了较低的 DBP，该模型可以作为高血压患者的一种策略。
OBJECTIVE: To evaluate the effectiveness of a community pharmacist-based home blood pressure (BP) monitoring program.DESIGN: Trial of a high-intensity (HI) versus low-intensity (LI) intervention randomized in 12 community pharmacies. The HI intervention comprised 4 face-to-face visits with a trained pharmacist. Pharmacists provided patient-specific education about hypertension. Following the first and third visits, patients were provided with a home BP monitoring device and instructed to measure their BP at least once daily for the next month. Home BP readings were used by the pharmacists to develop treatment recommendations for the patient's physician. Recommendations were discussed with the physician and, if approved, implemented by the pharmacist. In the LI intervention, pharmacists measured patients BP in the pharmacy and referred them to their physician for evaluation.PARTICIPANTS: Patients with uncontrolled BP at baseline.MEASUREMENTS: The main outcomes were the differences in systolic and diastolic BP (SBP and DBP) from baseline to follow-up between the HI and LI patients. RESULTS: The study enrolled 125 patients, 64 in the HI and 61 in the LI group. From baseline, SBP declined 13.4 mmHg in the HI group and 9.0 mmHg in the LI group. At the final visit, the difference in SBP/DBP change between the HI and LI group was -4.5/-3.2 mmHg (P=.12 for SBP and P=.03 for DBP).CONCLUSIONS: The HI intervention achieved a lower DBP and this model could be a strategy for patients with hypertension.