在社区药房和家庭医生诊所使用自动血压测量设备进行血压测量的比较：一项随机对照试验。
Comparison of blood pressure measurements using an automated blood pressure device in community pharmacies and family physicians' offices: a randomized controlled trial.
作者信息
Chambers Larry W, Kaczorowski Janusz, O'Rielly Susan, Ignagni Sandra, Hearps Stephen J C
机构信息
Bruyère Research Institute, Ottawa, Ont.
Department of Family and Emergency Medicine and the University of Montréal Hospital Research Centre, University of Montréal, Montréal, Que.
出版信息
CMAJ Open. 2013 Apr 9;1(1):E37-42. doi: 10.9778/cmajo.20130005. eCollection 2013 Jan.
BACKGROUND
Accurate measurement of blood pressure is the foundation of appropriate diagnosis, treatment and ongoing management of hypertension. The use of automated blood pressure devices in community settings such as pharmacies provide opportunities for additional blood pressure measurement; however, it is important to ensure that these measurements are comparable to those taken in physicians' offices using the same devices. We conducted a randomized controlled trial to assess whether blood pressure readings assessed by use of an automated device differed according to the setting, specifically in community pharmacies and family physicians' offices.
METHODS
We included adults aged 65 years and older who did not live in long-term care facilities or in hospital. The trial was administered by volunteer peer health educators, family physicians and pharmacists in 2 midsized communities in Ontario from April to September 2010. The 5 participating family physicians mailed invitations to their eligible patients. Those who gave informed consent were randomly allocated to 1 of 2 assessment sequences: group A had their blood pressure measured at their physician's office, then at a pharmacy, then again at their physician's office; those in group B had their blood pressure measured at a pharmacy, then at their physician's office, then again at a pharmacy. An automated blood pressure device (BpTRU) was used in both settings. We calculated the differences in mean systolic and diastolic blood pressure, and we compared the readings at both settings and by sequence of assessment.
RESULTS
In total, 275 adults completed the trial (mean age 75.9 yr, 49.5% male, 46.9% with a self-reported diagnosis of hypertension). There were no statistically significant differences in systolic or diastolic blood pressure measurements associated with the sequence of assessment or the setting. There was a significant difference in the overall mean systolic blood pressure between the 2 assessment sequences (group A 122.0 v. group B 127.8 mm Hg, p < 0.001).
INTERPRETATION
Automated devices used in pharmacies to measure blood pressure provide accurate and valid information that can be used in the diagnosis and management of hypertension among older adults in the community.
TRIAL REGISTRATION
www.controlled-trials.com, no. ISRCTN91799042.
背景
准确测量血压是高血压恰当诊断、治疗及持续管理的基础。在药房等社区环境中使用自动血压测量设备为增加血压测量提供了机会；然而，确保这些测量结果与在医生办公室使用相同设备所测结果具有可比性很重要。我们进行了一项随机对照试验，以评估使用自动设备所测血压读数是否因测量环境而异，特别是在社区药房和家庭医生办公室。
方法
我们纳入了年龄在65岁及以上、不住在长期护理机构或医院的成年人。该试验由志愿者同行健康教育者、家庭医生和药剂师于2010年4月至9月在安大略省的2个中等规模社区实施。5名参与的家庭医生向其符合条件的患者发出邀请。那些给予知情同意的患者被随机分配到2种评估顺序中的1种：A组先在医生办公室测量血压，然后在药房测量，之后再在医生办公室测量；B组先在药房测量血压，然后在医生办公室测量，之后再在药房测量。在两种环境中均使用了自动血压测量设备（BpTRU）。我们计算了收缩压和舒张压的平均差值，并比较了两种环境下以及按评估顺序的读数。
结果
共有275名成年人完成了试验（平均年龄75.9岁，49.5%为男性，46.9%自我报告患有高血压）。与评估顺序或测量环境相关的收缩压或舒张压测量值无统计学显著差异。两种评估顺序之间的总体平均收缩压存在显著差异（A组122.0对B组127.8 mmHg，p<0.001）。
解读
药房中用于测量血压的自动设备可提供准确有效的信息，可用于社区老年人高血压的诊断和管理。
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