Document Detail


Effects and cost-effectiveness of a guideline-oriented primary healthcare hypertension management program in Beijing, China: results from a 1-year controlled trial.
MedLine Citation:
PMID:  23154592     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Hypertension control rates are unacceptably low in China. The present study demonstrates if a customized, guideline-oriented training program can cost-effectively improve hypertension management in primary healthcare. Four typical community health centers in Beijing were selected and randomized to intervention or control (one urban and one rural each). A sample of 140 patients with hypertension and blood pressure uncontrolled was recruited from each center. Primary healthcare providers in intervention centers provided management to the recruited patients for 1 year after receiving training with customized hypertension management guidelines, and primary healthcare providers in control provided with usual care. Intention-to-treat analysis showed that hypertension control (systolic blood pressure (SBP) <140 mm Hg and diastolic blood pressure (DBP) <90 mm Hg)) rate was significantly higher in interventions than controls at month 3 (42.1% vs. 34.3% in urban and 30.7% vs. 10.0% in rural centers) and the trend increased to month 12 (70.7% vs. 40.0% in urban and 72.9% vs. 27.9% in rural); P-values by logistic mixed model were all <0.001 for both urban and rural after adjustment for baseline multiple variables including blood pressure. Mean reductions of SBP and DBP were significantly larger in interventions. The intervention was cost-saving, with an average incremental cost-saving of US$ 20.3 per patient in urban sites and $ 7.0 per patient in rural sites. Corresponding results from per-protocol analysis were very similar. The customized, guideline-oriented hypertension management program in primary healthcare in China effectively improved blood pressure control and was cost-saving.Hypertension Research advance online publication, 15 November 2012; doi:10.1038/hr.2012.173.
Authors:
Xin Wang; Weiqin Li; Xian Li; Ning An; Hao Chen; Stephen Jan; Guanghua Ming; Qi Hua; Xiaowei Yan; Ningling Sun; Dong Zhao; Yangfeng Wu
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-15
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  -     ISSN:  1348-4214     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China.
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