Birtwhistle Richard V, Godwin Marshall S, Delva M Dianne, Casson R Ian, Lam Miu, MacDonald Susan E, Seguin Rachelle, Rühland Lucia
Centre for Studies in Primary Care, Queen's University, PO Bag 8888, Kingston, ON, Canada K7L 5E9.
BMJ. 2004 Jan 24;328(7433):204. doi: 10.1136/bmj.37967.374063.EE. Epub 2004 Jan 15.
To compare blood pressure control, satisfaction, and adherence to drug treatment in patients with treated hypertension followed up by their family physicians either every three months or every six months for three years.
Randomised equivalence clinical trial. Settings 50 family practices in south eastern Ontario, Canada.
609 patients aged 30-74 years with essential hypertension receiving drug treatment whose hypertension had been controlled for at least three months before entry into the study.
302 patients were randomly assigned to follow up every three months and 307 to follow up every six months. Baseline variables in the two groups were similar. As expected, patients in the six month group had significantly fewer visits, but patients in both groups visited their doctor more frequently than their assigned interval. Mean blood pressure was similar in the groups, as was control of hypertension. Patient satisfaction and adherence to treatment were similar in the groups. About 20% of patients in each group had blood pressures that were out of control during the study.
Follow up of patients with treated essential hypertension every six months is equivalent to follow up every three months. Patient satisfaction and adherence to treatment are the same for these follow up intervals. As about 20% of patients' hypertension was out of control at any time during the study in both groups, the frequency of follow up may not the most important factor in the control of patients' hypertension by family practitioners.
比较由家庭医生每三个月或每六个月随访三年的高血压治疗患者的血压控制情况、满意度及药物治疗依从性。
随机等效性临床试验。地点为加拿大安大略省东南部的50个家庭医疗诊所。
609例年龄在30 - 74岁之间的原发性高血压患者，正在接受药物治疗，且在进入研究前其高血压已得到控制至少三个月。
302例患者被随机分配为每三个月随访一次，307例患者被随机分配为每六个月随访一次。两组的基线变量相似。正如预期的那样，六个月随访组的就诊次数显著较少，但两组患者的就诊频率均高于其指定的随访间隔。两组的平均血压相似，高血压控制情况也相似。两组患者的满意度和治疗依从性相似。每组中约20%的患者在研究期间血压失控。
原发性高血压治疗患者每六个月随访一次与每三个月随访一次等效。在这些随访间隔中，患者满意度和治疗依从性相同。由于两组中约20%的患者在研究期间的任何时候高血压都会失控，随访频率可能不是家庭医生控制患者高血压的最重要因素。
