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Mejorar el control de la hipertensión en la diabetes mellitus: los efectos de la comunicación de salud colaborativa y
Aanand D Naik1, Michael A Kallen, Annette Walder
1Houston Center for Quality of Care and Utilization Studies, Michael E. DeBakey VA Medical Center (152), 2002 Holcombe Blvd, Houston, TX 77030, USA. anaik@bcm.tmc.edu
Circulation
|March 5, 2008
Resumen
La comunicación efectiva entre el paciente y el médico, incluida la toma de decisiones compartida y las discusiones proactivas de autocontrol, mejora significativamente el control de la hipertensión en pacientes con diabetes. El establecimiento de objetivos colaborativos mejora aún más estos resultados positivos.
Área de la Ciencia:
- Cardiología Cardiología.
- Endocrinología Endocrinología.
- Servicios de salud Servicios de salud Investigación Investigación.
Sus antecedentes:
- El control de la hipertensión sigue siendo un desafío en la atención de la diabetes mellitus.
- Las estrategias de comunicación paciente-clínico pueden mitigar las barreras para el manejo efectivo de la hipertensión.
Objetivo del estudio:
- Para evaluar la interrelación de los factores de comunicación paciente-clínico.
- Determinar las asociaciones independientes de estos factores con el control de la hipertensión en el cuidado de la diabetes.
Principales métodos:
- Análisis de datos clínicos y farmacéuticos de 566 adultos mayores con diabetes e hipertensión.
- Cuestionarios de pacientes administrados para evaluar los factores de comunicación y las conductas de autogestión.
- Regresión logística y análisis de trayectoria para evaluar asociaciones con el control de la hipertensión.
Principales resultados:
- La toma de decisiones compartida (OR 1.61) y la comunicación proactiva sobre el autocontrol de la presión arterial (OR 1.89) mostraron asociaciones directas e independientes con el control de la hipertensión.
- La comunicación colaborativa de los médicos en el establecimiento de objetivos mejoró indirectamente el control de la hipertensión a través del estilo de toma de decisiones y la comunicación proactiva.
Conclusiones:
- Tres factores clave de comunicación tienen un impacto significativo en el control de la hipertensión en pacientes diabéticos.
- El establecimiento de objetivos colaborativos y la aportación del paciente mejoran el control de la hipertensión, independientemente de la adherencia a la medicación.
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