中国農村における血圧管理のための村の医師主導の多面的介入:オープンなクラスターランダム化試験
Yingxian Sun1, Jianjun Mu2, Dao Wen Wang3
1Department of Cardiology, First Hospital of China Medical University, Shenyang, China.
Lancet (London, England)
|May 2, 2022
まとめ
村の医師が主導した介入により 中国の農村部で 血圧のコントロールが著しく改善されました この多面的なアプローチは 薬剤管理と健康指導を含むもので 低所得者層の高血圧管理に 拡張可能な解決策を提供します
科学分野:
- 公衆衛生
- 心血管医学
- 医療サービス研究
背景:
- 高血圧の制御ができない状態は 特に低所得国や中所得国では 世界的に広がる健康問題です
- 中国の農村部では 患者の最前線での医療は 村の医師に大きく依存しています
- 高血圧制御率を向上させるには 有効な戦略が必要である.
研究 の 目的:
- 中国農村部の血圧管理を改善するための 村の医師による多面的な介入の有効性を評価する.
- 高血圧管理の成果に対する通常の治療の強化と比較して,この介入の影響を評価する.
- この介入戦略の実行可能性と拡張性を決定し,より広範に実施する.
主な方法:
- 中国地方の326の村を対象としたクラスターランダム化試験です.
- 介入グループは,薬の管理,健康指導,家庭での血圧モニタリングのサポートを含む,村の医師によるケアを受けた.
- 対照群は通常の治療を強化した. 高血圧の40歳以上の被験者を募った.
主要な成果:
- 村の医師主導の介入グループは,対照群 (19. 9%) と比較して18ヶ月で著しく高い血圧制御率を達成しました.
- 介入群の平均シストリック血圧は,対照群の - 11. 8 mm Hg 減少した.
- 対照群では7. 5 mm Hg であったが,深刻な有害事象は報告されなかった.
結論:
- 村の医師が率いる 多面的な介入により 中国の農村部で 血圧のコントロールが著しく改善されました
- この介入は高血圧管理の 実行可能で効果的で持続可能な戦略です
- このアプローチは 低所得国や中所得国でも 拡大の可能性があります
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