McClintock Heather F, Bogner Hillary R
Department of Community and Global Public Health, Arcadia University, 450 S. Easton Road, Glenside, PA, 19104, USA.
Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, 928 Blockley Hall, Philadelphia, PA, 19038, USA.
Community Ment Health J. 2017 Aug;53(6):703-710. doi: 10.1007/s10597-017-0131-x. Epub 2017 Apr 4.
The objective of this study was to carry out a randomized controlled pilot trial to test the effectiveness of an integrated intervention for hypertension and depression incorporating patients' social determinants of health (enhanced intervention) versus an integrated intervention alone (basic intervention). In all, 54 patients were randomized. An electronic monitor was used to measure blood pressure, and the nine-item Patient Health Questionnaire (PHQ-9) assessed depressive symptoms. Patients in the enhanced intervention had a significantly improved PHQ-9 mean change from baseline in comparison with patients in the basic intervention group at 12 weeks (p = 0.024). Patients in the enhanced intervention had a significantly improved systolic and diastolic blood pressure mean change from baseline in comparison with patients in the basic intervention group at 12 weeks (p = 0.003 and p = 0.019, respectively). Our pilot trial results indicate integrated care management that addresses the social determinants of health for patients with hypertension and depression may be effective.
本研究的目的是开展一项随机对照试验，以测试纳入患者健康社会决定因素的高血压与抑郁症综合干预措施（强化干预）相对于单纯综合干预措施（基础干预）的有效性。总共54名患者被随机分组。使用电子监测仪测量血压，并采用九项患者健康问卷（PHQ-9）评估抑郁症状。在12周时，强化干预组患者的PHQ-9平均变化较基础干预组患者从基线水平有显著改善（p = 0.024）。在12周时，强化干预组患者的收缩压和舒张压平均变化较基础干预组患者从基线水平有显著改善（分别为p = 0.003和p = 0.019）。我们的试点试验结果表明，针对高血压和抑郁症患者的健康社会决定因素进行综合护理管理可能是有效的。
