Khan Nadia, Bacon Simon L, Khan Samia, Perlmutter Sara, Gerlinsky Carline, Dermer Mark, Johnson Lonni, Alves Finderson, McLean Donna, Laupacis Andreas, Pui Mandy, Berg Angelique, Flowitt Felicia
Division of General Internal Medicine, University of British Columbia, Vancouver, BC, Canada.
Center for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada.
J Clin Hypertens (Greenwich). 2017 Nov;19(11):1063-1069. doi: 10.1111/jch.13091. Epub 2017 Sep 25.
Patient- and stakeholder-oriented research is vital to improving the relevance of research. The authors aimed to identify the 10 most important research priorities of patients, caregivers, and healthcare providers (family physicians, nurses, nurse practitioners, pharmacists, and dietitians) for hypertension management. Using the James Lind Alliance approach, a national web-based survey asked patients, caregivers, and care providers to submit their unanswered questions on hypertension management. Questions already answered from randomized controlled trial evidence were removed. A priority setting process of patient, caregiver, and healthcare providers then ranked the final top 10 research priorities in an in-person meeting. There were 386 respondents who submitted 598 questions after exclusions. Of the respondents, 78% were patients or caregivers, 29% lived in rural areas, 78% were aged 50 to 80 years, and 75% were women. The 598 questions were distilled to 42 unique questions and from this list, the top 10 research questions prioritized included determining the combinations of healthy lifestyle modifications to reduce the need for antihypertensive medications, stress management interventions, evaluating treatment strategies based on out-of-office blood pressure compared with conventional (office) blood pressure, education tools and technologies to improve patient motivation and health behavior change, management strategies for ethnic groups, evaluating natural and alternative treatments, and the optimal role of different healthcare providers and caregivers in supporting patients with hypertension. These priorities can be used to guide clinicians, researchers, and funding bodies on areas that are a high priority for hypertension management research for patients, caregivers, and healthcare providers. This also highlights priority areas for improved knowledge translation and delivering patient-centered care.
以患者和利益相关者为导向的研究对于提高研究的相关性至关重要。作者旨在确定患者、护理人员以及医疗保健提供者（家庭医生、护士、执业护士、药剂师和营养师）在高血压管理方面最重要的10项研究重点。采用詹姆斯·林德联盟方法，通过一项全国性的网络调查，要求患者、护理人员和医疗服务提供者提交他们在高血压管理方面未解决的问题。已从随机对照试验证据中得到解答的问题被排除。患者、护理人员和医疗保健提供者的优先事项设定过程随后在一次面对面会议上对最终的前10项研究重点进行了排名。共有386名受访者在排除后提交了598个问题。在受访者中，78%为患者或护理人员，29%生活在农村地区，78%年龄在50至80岁之间，75%为女性。598个问题被提炼为42个独特问题，从这份清单中，优先排序的前10项研究问题包括确定健康生活方式改变的组合以减少抗高血压药物的需求、压力管理干预措施、基于诊室外血压与传统（诊室）血压比较来评估治疗策略、提高患者动机和健康行为改变的教育工具和技术、针对不同种族群体的管理策略、评估天然和替代疗法，以及不同医疗保健提供者和护理人员在支持高血压患者方面的最佳作用。这些重点可用于指导临床医生、研究人员和资助机构关注对患者、护理人员和医疗保健提供者而言高血压管理研究的高度优先领域。这也突出了知识转化和提供以患者为中心的护理的优先领域。
