| Effectiveness of a two-part educational intervention to improve hypertension control: a cluster-randomized trial. | |
| | |
MedLine Citation:
|
PMID: 16945057 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
STUDY OBJECTIVE: To measure the effectiveness of a multifaceted educational intervention to improve ambulatory hypertension control. DESIGN: Cluster-randomized trial. SETTING: Academic health system using an ambulatory electronic medical record. SUBJECTS: A total of 10,696 patients with a diagnosis of hypertension cared for by 93 primary care providers. INTERVENTION: Academic detailing, provision of provider-specific data about hypertension control, provision of educational materials to the provider, and provision of educational and motivational materials to patients. MEASUREMENTS AND MAIN RESULTS: The primary outcome was blood pressure control, defined as a blood pressure measurement below 140/90 mm Hg, and was ascertained from electronic medical records over 6 months of follow-up. We determined the adjusted odds ratio for the association between the intervention and the achievement of controlled blood pressure. When we accounted for clustering by provider, this adjusted odds ratio was 1.13 (95% confidence interval 0.87-1.47). Adjusted odds ratios were 1.03 (95% confidence interval 0.78-1.36) in patients whose blood pressure was controlled at baseline and 1.25 (95% confidence interval 0.94-1.65) in those whose blood pressure was not. These odds ratios were not significantly different (p=0.11). CONCLUSIONS: These results were consistent with no effect or, at best, a relatively modest effect of the intervention among patients with hypertension. Had we not included a concurrent control group, the data would have provided an unduly optimistic view of the effectiveness of the program. The effectiveness of future interventions may be improved by focusing on patients whose blood pressure is uncontrolled at baseline. |
| | |
Authors:
|
Sean Hennessy; Charles E Leonard; Wei Yang; Stephen E Kimmel; Raymond R Townsend; Alan G Wasserstein; Thomas R Ten Have; Warren B Bilker |
Related Documents
:
|
11411737 - Efficacy of candesartan cilexetil as add-on therapy in hypertensive patients uncontroll... 12417537 - Calcium antagonist lacidipine slows down progression of asymptomatic carotid atheroscle... 21605247 - Rapid induction of suction blisters by intra-cavity positive pressure enhancement. 8466377 - Weight loss intervention in phase 1 of the trials of hypertension prevention. the tohp ... 8890757 - Nitric oxide in vascular remodeling. 17572927 - Progressive fetal atrioventricular block in heterotaxy syndrome. |
Publication Detail:
|
Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Pharmacotherapy Volume: 26 ISSN: 0277-0008 ISO Abbreviation: Pharmacotherapy Publication Date: 2006 Sep |
Date Detail:
|
Created Date: 2006-09-01 Completed Date: 2007-01-10 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8111305 Medline TA: Pharmacotherapy Country: United States |
Other Details:
|
Languages: eng Pagination: 1342-7 Citation Subset: IM |
Affiliation:
|
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. shenness@cceb.med.upenn.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Antihypertensive Agents
/
therapeutic use Blood Pressure Female Humans Hypertension / drug therapy, prevention & control* Male Middle Aged Patient Education as Topic* Pharmacists |
| Grant Support | |
ID/Acronym/Agency:
|
K23AG000987/AG/NIA NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Antihypertensive Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Coronary artery disease and hypertension: outcomes of a pharmacist-managed blood pressure program.
Next Document: Acute renal failure during lisinopril and losartan therapy for proteinuria.