BACKGROUND: To improve hypertension control, this cluster randomized trial evaluated the effectiveness of physician manager education about hypertension management. METHODS: After randomization at practice level, primary care physicians of the intervention arm, whose practices collaborated with a university department, participated in a three-session education on evidence-based hypertensiology and practice implementation strategies. The primary outcome was blood pressure (BP) control (ambulatory blood pressure [ABP] <130/80 mmHg) after 5 months. Secondary outcomes were changes in BP and practice routines regarding hypertension management. Following an intention-to-treat approach, data analyses included crude and adjusted generalized mixed models and sensitivity analyses. These took into account sex, age, ≥ hypertension-related disease and resistant hypertension (RH). RESULTS: The analysis included 103 of 169 patients from 22 practices. Overall, BP decrease was -8.2 systolic and -4.1 mmHg diastolic. The intervention had no effect on BP control (odds ratio 0.84 [95% CI 0.29-2.43]) and BP changes (interventional effect: systolic -2.48 mmHg [95% CI -7.24 to 2.29], diastolic -0.25 mmHg [95% CI 3.31 to 2.82]). Sensitivity analysis indicated effect modification in patients with RH. Intervention practices requested educational input on difficult cases, and newly implemented 3 practice strategies (14.5±2.6 versus 11.4±2.2; P=0.005). CONCLUSION: After the short follow-up of 5 months, the intervention had no impact on BP control but improved the use of practice strategies.
RCT Entities:
BACKGROUND: To improve hypertension control, this cluster randomized trial evaluated the effectiveness of physician manager education about hypertension management. METHODS: After randomization at practice level, primary care physicians of the intervention arm, whose practices collaborated with a university department, participated in a three-session education on evidence-based hypertensiology and practice implementation strategies. The primary outcome was blood pressure (BP) control (ambulatory blood pressure [ABP] <130/80 mmHg) after 5 months. Secondary outcomes were changes in BP and practice routines regarding hypertension management. Following an intention-to-treat approach, data analyses included crude and adjusted generalized mixed models and sensitivity analyses. These took into account sex, age, ≥ hypertension-related disease and resistant hypertension (RH). RESULTS: The analysis included 103 of 169 patients from 22 practices. Overall, BP decrease was -8.2 systolic and -4.1 mmHg diastolic. The intervention had no effect on BP control (odds ratio 0.84 [95% CI 0.29-2.43]) and BP changes (interventional effect: systolic -2.48 mmHg [95% CI -7.24 to 2.29], diastolic -0.25 mmHg [95% CI 3.31 to 2.82]). Sensitivity analysis indicated effect modification in patients with RH. Intervention practices requested educational input on difficult cases, and newly implemented 3 practice strategies (14.5±2.6 versus 11.4±2.2; P=0.005). CONCLUSION: After the short follow-up of 5 months, the intervention had no impact on BP control but improved the use of practice strategies.
Authors: Sean Hennessy; Charles E Leonard; Wei Yang; Stephen E Kimmel; Raymond R Townsend; Alan G Wasserstein; Thomas R Ten Have; Warren B Bilker Journal: Pharmacotherapy Date: 2006-09 Impact factor: 4.705
Authors: Christianne L Roumie; Tom A Elasy; Robert Greevy; Marie R Griffin; Xulei Liu; William J Stone; Kenneth A Wallston; Robert S Dittus; Vincent Alvarez; Janice Cobb; Theodore Speroff Journal: Ann Intern Med Date: 2006-08-01 Impact factor: 25.391
Authors: Stefan Lüders; Joachim Schrader; Roland E Schmieder; Wenefrieda Smolka; Karl Wegscheider; Kurt Bestehorn Journal: Eur J Cardiovasc Prev Rehabil Date: 2010-06
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Authors: Barry L Carter; George R Bergus; Jeffrey D Dawson; Karen B Farris; William R Doucette; Elizabeth A Chrischilles; Arthur J Hartz Journal: J Clin Hypertens (Greenwich) Date: 2008-04 Impact factor: 3.738