Effectiveness of multidisciplinary intervention on blood pressure control in primary health care : a randomized clinical trial
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/158783 |
Resumo: | Background: Hypertension is a public health problem and a major risk factor for cardiovascular disease. The purpose of this study is to compare the effectiveness of a multidisciplinary program based on group and individual care versus group-only care, to promote blood pressure control in hypertensive patients in primary health care. Methods: Randomized controlled clinical trial. The study was conducted within the primary health care, in two units of the Family Health Strategy, covering 11,000 individuals, in Porto Alegre, Brazil. Two hundred and 56 patients, older than 40 years old and with uncontrolled hypertension, systolic blood pressure (BP) ≥140 mmHg and/or diastolic BP ≥90 mmHg or ≥130 mmHg and/or diastolic BP ≥80 mmHg for individuals with diabetes. Eligible patients were randomly assigned to a health care program aiming for blood pressure control, with the multidisciplinary program group or with the multidisciplinary program plus personalized care group. Primary outcome measures were reduction in systolic BP from baseline to 6 months. Secondary measures included proportion of patients with systolic or diastolic BP controlled. Student t test, Pearson’s chi-squared test, Fisher’s exact test, Mann-Whitney U test, Wilcoxon signed-ranks test and generalized estimating equation (GEE) model were used in the analysis. Results: The baseline characteristics of participants were similar between groups. After 6 months of follow-up, systolic BP decreased markedly in both groups (Δ - 11.8 mmHg [SD, 20.2] in the multidisciplinary program group and Δ - 12.9 mmHg [SD, 19.2] in the personalized care group; p < 0.001). Similarly, we noted a significant change in diastolic BP over time in both groups (Δ - 8.1 mmHg [SD, 10.8] in the multidisciplinary program group and Δ - 7. 0 mmHg [SD, 11.5] in the personalized care group; p < 0.001). Conclusions: The study demonstrates similar effectiveness of a group intervention in comparison to a personalized education program in hypertension patients to achieve BP control. These findings indicate that the intervention can be for all hypertensive patients assisted in primary health care.Trial registration: ClinicalTrials.gov IdentifierNCT01696318 (May 2013). |
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Notti, Regina KuhmmerLazzaretti, Rosmeri KuhmmerGuterres, Cátia MoreiraRaimundo, Fabiana ViegasLeite, Leni Everson AraújoDelabary, Tássia ScholanteCaon, SuhélenBastos, Gisele Alsina NaderPolanczyk, Carisi Anne2017-05-30T02:37:50Z20161472-6963http://hdl.handle.net/10183/158783001014193Background: Hypertension is a public health problem and a major risk factor for cardiovascular disease. The purpose of this study is to compare the effectiveness of a multidisciplinary program based on group and individual care versus group-only care, to promote blood pressure control in hypertensive patients in primary health care. Methods: Randomized controlled clinical trial. The study was conducted within the primary health care, in two units of the Family Health Strategy, covering 11,000 individuals, in Porto Alegre, Brazil. Two hundred and 56 patients, older than 40 years old and with uncontrolled hypertension, systolic blood pressure (BP) ≥140 mmHg and/or diastolic BP ≥90 mmHg or ≥130 mmHg and/or diastolic BP ≥80 mmHg for individuals with diabetes. Eligible patients were randomly assigned to a health care program aiming for blood pressure control, with the multidisciplinary program group or with the multidisciplinary program plus personalized care group. Primary outcome measures were reduction in systolic BP from baseline to 6 months. Secondary measures included proportion of patients with systolic or diastolic BP controlled. Student t test, Pearson’s chi-squared test, Fisher’s exact test, Mann-Whitney U test, Wilcoxon signed-ranks test and generalized estimating equation (GEE) model were used in the analysis. Results: The baseline characteristics of participants were similar between groups. After 6 months of follow-up, systolic BP decreased markedly in both groups (Δ - 11.8 mmHg [SD, 20.2] in the multidisciplinary program group and Δ - 12.9 mmHg [SD, 19.2] in the personalized care group; p < 0.001). Similarly, we noted a significant change in diastolic BP over time in both groups (Δ - 8.1 mmHg [SD, 10.8] in the multidisciplinary program group and Δ - 7. 0 mmHg [SD, 11.5] in the personalized care group; p < 0.001). Conclusions: The study demonstrates similar effectiveness of a group intervention in comparison to a personalized education program in hypertension patients to achieve BP control. These findings indicate that the intervention can be for all hypertensive patients assisted in primary health care.Trial registration: ClinicalTrials.gov IdentifierNCT01696318 (May 2013).application/pdfengBMC health services research. London. Vol. 16, (Aug. 2016), 456, 13 p.HipertensãoSaúde públicaPressão sanguíneaDiabetes mellitusHypertensionPublic healthMultidisciplinary programSystolic blood pressureDiastolic blood pressureDiabetes MellitusEffectiveness of multidisciplinary intervention on blood pressure control in primary health care : a randomized clinical trialEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSORIGINAL001014193.pdf001014193.pdfTexto completo (inglês)application/pdf615406http://www.lume.ufrgs.br/bitstream/10183/158783/1/001014193.pdf1c11d36c8584c48f7d1fde0458d82ffdMD51TEXT001014193.pdf.txt001014193.pdf.txtExtracted Texttext/plain54396http://www.lume.ufrgs.br/bitstream/10183/158783/2/001014193.pdf.txtea801c458ba5c1d86be1682f072c03a9MD52THUMBNAIL001014193.pdf.jpg001014193.pdf.jpgGenerated Thumbnailimage/jpeg1763http://www.lume.ufrgs.br/bitstream/10183/158783/3/001014193.pdf.jpgb8ec6ddefc97697e638c935017f7c2b9MD5310183/1587832023-05-20 03:53:39.841704oai:www.lume.ufrgs.br:10183/158783Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-05-20T06:53:39Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Effectiveness of multidisciplinary intervention on blood pressure control in primary health care : a randomized clinical trial |
title |
Effectiveness of multidisciplinary intervention on blood pressure control in primary health care : a randomized clinical trial |
spellingShingle |
Effectiveness of multidisciplinary intervention on blood pressure control in primary health care : a randomized clinical trial Notti, Regina Kuhmmer Hipertensão Saúde pública Pressão sanguínea Diabetes mellitus Hypertension Public health Multidisciplinary program Systolic blood pressure Diastolic blood pressure Diabetes Mellitus |
title_short |
Effectiveness of multidisciplinary intervention on blood pressure control in primary health care : a randomized clinical trial |
title_full |
Effectiveness of multidisciplinary intervention on blood pressure control in primary health care : a randomized clinical trial |
title_fullStr |
Effectiveness of multidisciplinary intervention on blood pressure control in primary health care : a randomized clinical trial |
title_full_unstemmed |
Effectiveness of multidisciplinary intervention on blood pressure control in primary health care : a randomized clinical trial |
title_sort |
Effectiveness of multidisciplinary intervention on blood pressure control in primary health care : a randomized clinical trial |
author |
Notti, Regina Kuhmmer |
author_facet |
Notti, Regina Kuhmmer Lazzaretti, Rosmeri Kuhmmer Guterres, Cátia Moreira Raimundo, Fabiana Viegas Leite, Leni Everson Araújo Delabary, Tássia Scholante Caon, Suhélen Bastos, Gisele Alsina Nader Polanczyk, Carisi Anne |
author_role |
author |
author2 |
Lazzaretti, Rosmeri Kuhmmer Guterres, Cátia Moreira Raimundo, Fabiana Viegas Leite, Leni Everson Araújo Delabary, Tássia Scholante Caon, Suhélen Bastos, Gisele Alsina Nader Polanczyk, Carisi Anne |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Notti, Regina Kuhmmer Lazzaretti, Rosmeri Kuhmmer Guterres, Cátia Moreira Raimundo, Fabiana Viegas Leite, Leni Everson Araújo Delabary, Tássia Scholante Caon, Suhélen Bastos, Gisele Alsina Nader Polanczyk, Carisi Anne |
dc.subject.por.fl_str_mv |
Hipertensão Saúde pública Pressão sanguínea Diabetes mellitus |
topic |
Hipertensão Saúde pública Pressão sanguínea Diabetes mellitus Hypertension Public health Multidisciplinary program Systolic blood pressure Diastolic blood pressure Diabetes Mellitus |
dc.subject.eng.fl_str_mv |
Hypertension Public health Multidisciplinary program Systolic blood pressure Diastolic blood pressure Diabetes Mellitus |
description |
Background: Hypertension is a public health problem and a major risk factor for cardiovascular disease. The purpose of this study is to compare the effectiveness of a multidisciplinary program based on group and individual care versus group-only care, to promote blood pressure control in hypertensive patients in primary health care. Methods: Randomized controlled clinical trial. The study was conducted within the primary health care, in two units of the Family Health Strategy, covering 11,000 individuals, in Porto Alegre, Brazil. Two hundred and 56 patients, older than 40 years old and with uncontrolled hypertension, systolic blood pressure (BP) ≥140 mmHg and/or diastolic BP ≥90 mmHg or ≥130 mmHg and/or diastolic BP ≥80 mmHg for individuals with diabetes. Eligible patients were randomly assigned to a health care program aiming for blood pressure control, with the multidisciplinary program group or with the multidisciplinary program plus personalized care group. Primary outcome measures were reduction in systolic BP from baseline to 6 months. Secondary measures included proportion of patients with systolic or diastolic BP controlled. Student t test, Pearson’s chi-squared test, Fisher’s exact test, Mann-Whitney U test, Wilcoxon signed-ranks test and generalized estimating equation (GEE) model were used in the analysis. Results: The baseline characteristics of participants were similar between groups. After 6 months of follow-up, systolic BP decreased markedly in both groups (Δ - 11.8 mmHg [SD, 20.2] in the multidisciplinary program group and Δ - 12.9 mmHg [SD, 19.2] in the personalized care group; p < 0.001). Similarly, we noted a significant change in diastolic BP over time in both groups (Δ - 8.1 mmHg [SD, 10.8] in the multidisciplinary program group and Δ - 7. 0 mmHg [SD, 11.5] in the personalized care group; p < 0.001). Conclusions: The study demonstrates similar effectiveness of a group intervention in comparison to a personalized education program in hypertension patients to achieve BP control. These findings indicate that the intervention can be for all hypertensive patients assisted in primary health care.Trial registration: ClinicalTrials.gov IdentifierNCT01696318 (May 2013). |
publishDate |
2016 |
dc.date.issued.fl_str_mv |
2016 |
dc.date.accessioned.fl_str_mv |
2017-05-30T02:37:50Z |
dc.type.driver.fl_str_mv |
Estrangeiro info:eu-repo/semantics/article |
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info:eu-repo/semantics/publishedVersion |
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article |
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http://hdl.handle.net/10183/158783 |
dc.identifier.issn.pt_BR.fl_str_mv |
1472-6963 |
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001014193 |
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http://hdl.handle.net/10183/158783 |
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eng |
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BMC health services research. London. Vol. 16, (Aug. 2016), 456, 13 p. |
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openAccess |
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