Research Triangle Park, NC, USA.
J Clin Hypertens (Greenwich). 2011 Jul;13(7):517-22. doi: 10.1111/j.1751-7176.2011.00469.x. Epub 2011 Apr 22.
An increased focus on hypertension prevention and control, especially in high-risk populations, may have a substantial impact on cardiovascular health outcomes. A continuing medical education (CME) program trained primary care providers in evidence-based guidelines for hypertension prevention and control. This study evaluated its effectiveness in reducing patients' blood pressure for the sessions occurring from 2003 to 2007. Using the Hypertension Initiative Database, 8183 patients of CME providers (CME patients) were paired with controls and changes in blood pressure, provider visits, prescription months, and the proportion of patients with blood pressure <140/90 mm Hg before and after the intervention date were estimated. In the 2-year period before training and the 2-year period afterwards, CME patients' systolic blood pressure decreased by 1.99 mm Hg and diastolic blood pressure decreased by 1.49 mm Hg. The CME patients displayed an increase in provider visits but no statistically significant change in prescription months. Restricting the analysis to the subsample of patients with uncontrolled hypertension (>140/90 mm Hg), the changes in blood pressure were similar in magnitude to those in the entire population. The CME program, by promoting evidence-based practice, improves patients' blood pressure and could serve as a positive model for future hypertension interventions.
更加关注高血压的预防和控制,特别是在高危人群中,可能对心血管健康结果产生重大影响。一个继续医学教育(CME)项目培训了初级保健提供者有关高血压预防和控制的循证指南。本研究评估了该项目在降低患者血压方面的效果,研究对象为 2003 年至 2007 年期间参加课程的患者。研究人员使用高血压倡议数据库,将 CME 提供者的 8183 名患者(CME 患者)与对照组进行匹配,并估计了干预日期前后血压、就诊次数、处方月数以及血压<140/90mmHg 的患者比例的变化。在培训前的 2 年和培训后的 2 年内,CME 患者的收缩压下降了 1.99mmHg,舒张压下降了 1.49mmHg。CME 患者的就诊次数有所增加,但处方月数没有统计学上的显著变化。将分析限制在未经控制的高血压患者(>140/90mmHg)的亚样本中,血压的变化与整个人群的变化幅度相似。CME 项目通过推广循证实践,改善了患者的血压水平,可以作为未来高血压干预的积极模式。