Cheema Ejaz, Sutcliffe Paul, Weickert Martin O, Singer Donald R J
Warwick Medical School, Gibbet Hill Campus, University of Warwick, Coventry, CV4 7AL, UK.
WISDEM Centre, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Eur J Clin Pharmacol. 2018 Nov;74(11):1391-1395. doi: 10.1007/s00228-018-2519-0. Epub 2018 Jul 18.
This study was aimed to determine whether structured written and verbal education provided to patients by community pharmacists about high blood pressure (BP) and its treatment would be (a) better retained and (b) be associated with improved BP control as compared to patients receiving verbal advice only.
The study was designed as a randomised controlled trial and was conducted in the West Midlands, UK, between January 2014 and June 2014. The primary outcome measures were differences in systolic and diastolic BP from baseline and retention of information about high BP assessed with a questionnaire at 2-, 4- and 26-week follow-up points.
A total of 64 adults were included in the study. At the week 26 follow-up, compared to participants in the control group, there was a significant improvement in the knowledge of intervention participants about the risks associated with high BP (p < 0.001) and awareness about potential adverse effects of the new BP medicine (p < 0.001). Similarly, there was a greater and more significant reduction in systolic BP in favour of the intervention group 8 mmHg (95% CI 2.1-13.3 p = 0.009) compared to 6 mmHg (95% CI 0.6-11.7 p = 0.02) in the control group at the week 4 follow-up. However, this greater effect of an intervention on BP was not sustained at the 26-week follow-up. For diastolic BP, there was no added effect of the intervention.
This randomised controlled trial suggests that although written advice provided by community pharmacists in comparison to verbal advice was more effective in improving knowledge and understanding of patients about hypertension and its treatment, it did not lead to better blood pressure control.
本研究旨在确定社区药剂师为患者提供的关于高血压及其治疗的结构化书面和口头教育是否(a)能被更好地记住,以及(b)与仅接受口头建议的患者相比,是否能改善血压控制。
该研究设计为随机对照试验,于2014年1月至2014年6月在英国西米德兰兹郡进行。主要结局指标为收缩压和舒张压与基线的差异,以及在2周、4周和26周随访时通过问卷评估的高血压信息保留情况。
共有64名成年人纳入该研究。在26周随访时,与对照组参与者相比,干预组参与者对高血压相关风险的知识(p < 0.001)以及对新血压药物潜在不良反应的知晓率(p < 0.001)有显著改善。同样,在4周随访时,干预组收缩压的降低幅度更大且更显著,为8 mmHg(95%CI 2.1 - 13.3,p = 0.009),而对照组为6 mmHg(95%CI 0.6 - 11.7,p = 0.02)。然而,干预对血压的这种更大效果在26周随访时未持续。对于舒张压,干预没有额外效果。
这项随机对照试验表明,尽管与口头建议相比,社区药剂师提供的书面建议在提高患者对高血压及其治疗的知识和理解方面更有效,但它并未带来更好的血压控制。