Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC USA ; Department of Medicine, Division of General Internal Medicine, Duke University, 2424 Erwin Road, Hock Plaza, Durham, NC 27703 USA ; Department of Psychiatry and Behavioral Sciences, School of Nursing, & Center for Aging and Human Development, Duke University, Durham, NC USA.
Transl Behav Med. 2011 Mar;1(1):191-9. doi: 10.1007/s13142-010-0007-x.
Elevated blood pressure can lead to serious patient morbidity and mortality. The aim of the study was to evaluate the implementation of a tailored multifaceted program, administered by care managers in a Medicaid setting to improve hypertension medication adherence. The program enrolled 558 Medicaid patients. Patients had at least one phone call by care managers. The individually tailored program focused on improving lifestyle and medication adherence. The primary outcome was the medication possession ratio (MPR), calculated using fill history from pharmacy claims. We observed an improvement of medication possession from 55% 9-12 months prior to program enrollment to 77% 9-12 months post initiation of the program. We demonstrated 12 month sustainability and increased MPR. Personal interaction by phone allows the intervention to be tailored to participants' current concerns, health goals, and specific barriers to achieving these goals.
血压升高可导致严重的患者发病率和死亡率。本研究旨在评估在医疗补助环境中由护理经理实施的一项量身定制的多方面计划，以提高高血压药物治疗的依从性。该计划招募了 558 名医疗补助患者。患者至少接受过一次护理经理的电话访问。该个性化计划专注于改善生活方式和药物依从性。主要结果是用药比例（MPR），通过从药房索赔中计算出的用药记录来计算。我们观察到药物使用从计划开始前 9-12 个月的 55%到计划开始后 9-12 个月的 77%有所改善。我们证明了 12 个月的可持续性和更高的 MPR。通过电话进行的个人互动可以使干预措施针对参与者当前的关注点、健康目标和实现这些目标的具体障碍进行调整。
