一个多组件干预措施,以改善治疗依从性在初级保健水平内不受控制的高血压患者:一个前后的研究
Pablo Elías Gulayin1,2, Laura Gutierrez3, Diana Pinto3
1Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, C1414CPV, Buenos Aires, Argentina. pgulayin@iecs.org.ar.
概括
多组分干预显著改善了高血压患者的药物坚持和降低了血压. 这项公共初级保健计划在超过一半的参与者中实现了血压控制.
科学领域:
- 公共卫生 公共卫生
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 药物不服药是有效治疗慢性疾病的重要障碍.
- 控制高血压对于预防心血管并发症至关重要.
研究的目的:
- 评估多组分干预对抗高血压药物坚持的影响.
- 评估该干预措施对阿根廷公共初级保健系统中未经控制的高血压患者降低血压的影响.
主要方法:
- 在五个初级保健诊所进行了前后研究.
- 125名不受控制的高血压患者接受了基于慢性护理模型和5A策略的6个月的干预.
- 药物占有率 (MPR) 和血压 (BP) 在干预前后进行测量.
主要成果:
- 适当的药物坚持 (MPR ≥80%) 从16.8%显著增加到47.2% (p <0.001).
- 平均静脉血压下降了16.4 mmHg,静脉血压下降了12.0 mmHg (p < 0.001).
- 在6个月后,51.2%的患者实现了血压控制 (SBP < 140/DBP < 90 mmHg).
结论:
- 多组件干预有效提高了药物坚持率.
- 这种干预导致了缩和腹缩血压的显著降低.
- 超过一半的参与患者实现了目标血压控制.
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