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本文引用的文献

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Antihypertensive medication adherence and blood pressure control among central Alabama veterans.阿拉巴马州中部退伍军人的抗高血压药物依从性和血压控制情况
J Clin Hypertens (Greenwich). 2017 May;19(5):543-549. doi: 10.1111/jch.12953. Epub 2016 Dec 5.
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2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8).2014 年成人高血压管理的循证指南:第八届联合国家委员会(JNC 8)任命的专家组报告。
JAMA. 2014 Feb 5;311(5):507-20. doi: 10.1001/jama.2013.284427.
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2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines.2013年美国心脏病学会基金会/美国心脏协会心力衰竭管理指南:美国心脏病学会基金会/美国心脏协会实践指南工作组报告
Circulation. 2013 Oct 15;128(16):e240-327. doi: 10.1161/CIR.0b013e31829e8776. Epub 2013 Jun 5.
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Vital signs: awareness and treatment of uncontrolled hypertension among adults--United States, 2003-2010.生命体征:美国 2003-2010 年成年人高血压控制不良的意识和治疗。
MMWR Morb Mortal Wkly Rep. 2012 Sep 7;61:703-9.
5
Blood pressure control among US veterans: a large multiyear analysis of blood pressure data from the Veterans Administration health data repository.美国退伍军人的血压控制:来自退伍军人管理局健康数据存储库的多年大型血压数据分析。
Circulation. 2012 May 22;125(20):2462-8. doi: 10.1161/CIRCULATIONAHA.111.029983. Epub 2012 Apr 19.
6
Pharmacist-led shared medical appointments for multiple cardiovascular risk reduction in patients with type 2 diabetes.药师主导的共同医疗预约以降低 2 型糖尿病患者的多种心血管风险
Diabetes Educ. 2011 Nov-Dec;37(6):801-12. doi: 10.1177/0145721711423980. Epub 2011 Oct 21.

共享医疗预约对退伍军人事务医疗系统中高血压临床结局和药物依从性的影响。

Impact of a Shared Medical Appointment on Hypertension Clinical Outcomes and Medication Adherence in a Veterans Affairs Health Care System.

作者信息

Kirk Cain Eric, Gordon Autumn N, Mooney Kelly D, Aikens Garrett B, Robinson Michael H, Howard Molly E

机构信息

Montgomery VA Clinic, Central Alabama Veterans Health Care System, Montgomery, AL, USA.

Ft. Benning VA Clinic, Central Alabama Veterans Health Care System, Ft. Benning, GA, USA.

出版信息

J Pharm Technol. 2017 Oct;33(5):177-182. doi: 10.1177/8755122517714578. Epub 2017 Jun 19.

DOI:10.1177/8755122517714578
PMID:34860969
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5998423/
Abstract

Shared medical appointments (SMAs) are utilized across health care systems to improve access and quality of care, with limited evidence to support the use of SMAs to improve clinical outcomes and medication adherence among hypertensive patients. Improve access and quality of care provided within a Veterans Affairs health care system via implementation of a hypertension SMA to improve clinical outcomes and medication adherence. Veterans were eligible for enrollment in the SMA if they received care within the health care system, were aged ≥18 years, were receiving at least 2 antihypertensive medications, and had systolic blood pressure (SBP) >140 mm Hg or diastolic blood pressure (DBP) >90 mm Hg. A pre/post cohort design was used to evaluate the improvement in antihypertensive medication adherence as well as the change in SBP and DBP for all Veterans who attended at least 2 SMAs. Twenty-one Veterans participated in at least 2 SMAs and were included in the analysis; 76.2% had a reduction in SBP with an overall average decrease of -8.3 mm Hg ( = .02). The proportion of Veterans considered to have controlled blood pressure (BP; <140/90 mm Hg) increased from 14.3% at baseline to 42.9% during the SMA period ( = .03). There was no significant difference found for the proportion of Veterans considered adherent to their prescribed antihypertensive medications (95.2% vs 85.7%, respectively; = .50). SBP significantly improved for patients enrolled in a pharmacist-led SMA at a VA health care system, and the proportion of patients considered to have controlled BP increased significantly.

摘要

共享医疗预约(SMAs)在整个医疗保健系统中得到应用,以改善医疗服务的可及性和质量,但支持使用SMAs来改善高血压患者临床结局和药物依从性的证据有限。通过实施高血压SMAs来改善临床结局和药物依从性,从而提高退伍军人事务医疗保健系统内提供的医疗服务的可及性和质量。如果退伍军人在医疗保健系统内接受治疗、年龄≥18岁、正在服用至少2种抗高血压药物且收缩压(SBP)>140 mmHg或舒张压(DBP)>90 mmHg,则有资格参加SMAs。采用前后队列设计来评估所有参加至少2次SMAs的退伍军人的抗高血压药物依从性改善情况以及SBP和DBP的变化。21名退伍军人参加了至少2次SMAs并被纳入分析;76.2%的患者SBP有所下降,总体平均下降-8.3 mmHg(P = 0.02)。被认为血压得到控制(BP;<140/90 mmHg)的退伍军人比例从基线时的14.3%增加到SMAs期间的42.9%(P = 0.03)。在被认为坚持服用规定抗高血压药物的退伍军人比例方面未发现显著差异(分别为95.2%和85.7%;P = 0.50)。在退伍军人事务医疗保健系统中,参加由药剂师主导的SMAs的患者SBP显著改善,且被认为血压得到控制的患者比例显著增加。