Disability days associated with detection and treatment in a hypertension control program.
Disability days associated with detection and treatment in a hypertension control program.
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与高血压控制计划中的检测和治疗相关的残疾日。
DOI：
10.1093/oxfordjournals.aje.a113724
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发表时间：
1984
影响因子：
5
通讯作者：
T. Blaszkowski
中科院分区：
文献类型：
--
作者：
B. Polk;LINDA C. Harlan;SHARON POIZNER Cooper;Mitchell Stromer;Joan Ignatius;Helen Mull;T. Blaszkowski
将个体标记为高血压与缺勤率增加有关。在一项强化抗高血压治疗的临床试验中，对10,049名参与者在高血压筛查前后的残疾天数分布进行了比较。阶梯护理参与者前往特殊诊所，转诊护理参与者返回其通常的医疗服务来源。对于那些在筛选时不知道自己的高血压，残疾天增加基线和一年之间的转诊护理（n = 1805），而阶梯护理（n = 1842）参与者没有变化。无论是转诊治疗（n = 1868），也不是阶梯式护理（n = 1906）参与者知道，但在基线未治疗的残疾天在接下来的一年中报告的变化。对于那些在基线时意识到并接受治疗的患者，转诊护理中的残疾天数没有变化（n = 1275），但阶梯护理中报告了减少（n = 1353）。进一步的描述性分析表明，无论是标签单独或单独治疗与缺勤率增加。然而，检测和治疗与新诊断的转诊高血压患者的缺勤率增加有关，而在阶梯式护理诊所对既往治疗过的高血压患者的管理与缺勤率减少有关。由于后一种比较是在随机化后变量分层的组之间进行的，因此可能存在选择偏倚，必须谨慎解释。
Labeling individuals as hypertensive has been associated with increased absenteeism from work. Distributions of disability days were compared for the years before and after screening for hypertension among 10,049 participants in a clinical trial of intensive antihypertensive therapy. Stepped care participants attended special clinics and referred care participants returned to their usual sources of medical care. For those unaware of their hypertension at screening, disability days increased between baseline and one year among referred care (n = 1805), while there was no change among stepped care (n = 1842) participants. Neither referred care (n = 1868) nor stepped care (n = 1906) participants who were aware but untreated at baseline reported a change in disability days over the following year. For those aware and treated at baseline, there was no change in disability days in referred care (n = 1275), but a decrease was reported in stepped care (n = 1353). Further descriptive analyses suggest that neither labeling alone nor treatment alone was associated with increased absenteeism. However, detection and treatment were associated with increased absenteeism among newly diagnosed referred care hypertensives, while management of previously treated hypertensives in stepped care clinics was associated with reduced absenteeism. Because these latter comparisons are made between groups stratified on a postrandomization variable, selection bias is possible and interpretations must be made with caution.