University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN, USA.
Clin Transl Sci. 2013 Feb;6(1):7-12. doi: 10.1111/cts.12021. Epub 2013 Jan 14.
A time frame in which newly diagnosed hypertensive patients attain blood pressure (BP) goal would guide patients through uncertainty associated with initiating drug therapy for hypertension control. This study estimates time to BP goal resulting from drug therapy initiation among real-world hypertensive patients and identifies factors associated with variations in time to BP goal. The study uses a historical cohort design. Hypertensive patients who had initiated antihypertensive drug therapy between July 1, 2002, and December 31, 2003, were followed up to 12 months until the end of 2004. Electronic medical records from a medical group were linked with pharmacy claims, as well as with medical claims. Survival analyses were used to compare lengths of time needed to reach BP goals. A total of 223 patients from a real world practice setting had initiated antihypertensive drug therapy. The patients took 3.25 months (95% CI: 2.49-4.82) to reach BP goal. The patient-centric time to BP goal was 7.1 weeks longer than those reported in controlled experimental settings. This finding highlights the gap between results of controlled clinical trials and their application to clinical practice, and informs healthcare practitioners of the importance of setting a patient-centric goal in pharmacological treatment of hypertension.
新诊断的高血压患者达到血压（BP）目标的时间框架将指导患者克服与开始药物治疗高血压控制相关的不确定性。本研究估计了药物治疗开始后现实世界高血压患者达到 BP 目标的时间，并确定了与达到 BP 目标时间变化相关的因素。该研究使用了历史队列设计。2002 年 7 月 1 日至 2003 年 12 月 31 日期间开始抗高血压药物治疗的高血压患者被随访 12 个月，直至 2004 年底。医疗集团的电子病历与药房索赔以及医疗索赔相关联。生存分析用于比较达到 BP 目标所需的时间长度。共有 223 名来自真实实践环境的患者开始了抗高血压药物治疗。患者需要 3.25 个月（95%CI：2.49-4.82）达到 BP 目标。以患者为中心的 BP 目标时间比对照实验环境中报告的时间长 7.1 周。这一发现突出了对照临床试验结果与其在临床实践中的应用之间的差距，并告知医疗保健从业者在高血压药物治疗中设定以患者为中心的目标的重要性。
