Document Detail


The effect of a hypertension self-management intervention on diabetes and cholesterol control.
MedLine Citation:
PMID:  19559166     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Most patient chronic disease self-management interventions target single-disease outcomes. We evaluated the effect of a tailored hypertension self-management intervention on the unintended targets of glycosylated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C). METHODS: We evaluated patients from the Veterans Study to Improve the Control of Hypertension, a 2-year randomized controlled trial. Patients received either a hypertension self-management intervention delivered by a nurse over the telephone or usual care. Although the study focused on hypertension self-management, we compared changes in HbA1c among a subgroup of 216 patients with diabetes and LDL-C among 528 patients with measurements during the study period. Changes in these laboratory values over time were compared between the 2 treatment groups using linear mixed-effects models. RESULTS: For the patients with diabetes, the hypertension self-management intervention resulted in a 0.46% reduction in HbA1c over 2 years compared with usual care (95% confidence interval, 0.04%-0.89%; P = .03). For LDL-C, there was a minimal 0.9 mg/dL between-group difference that was not statistically significant (95% confidence interval, -7.3-5.6 mg/dL; P = .79). CONCLUSIONS: There was a significant effect of the self-management intervention on the unintended target of HbA1c, but not LDL-C. Chronic disease self-management interventions might have "spill-over" effects on patients' comorbid chronic conditions.
Authors:
Benjamin J Powers; Maren K Olsen; Eugene Z Oddone; Hayden B Bosworth
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American journal of medicine     Volume:  122     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-29     Completed Date:  2009-07-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  639-46     Citation Subset:  AIM; IM    
Affiliation:
Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC 27705, USA. power017@mc.duke.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Cholesterol, LDL / blood*
Diabetes Mellitus / therapy
Female
Hemoglobin A, Glycosylated / metabolism*
Humans
Hypertension / therapy*
Male
Middle Aged
Self Care*
Telemedicine*
Grant Support
ID/Acronym/Agency:
KL2 RR024127/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Cholesterol, LDL; 0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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