Lowe Beasley Kincaid, Tucker-Brown Aisha, Rein David B, Ahn Roy, Davis Rachel, Spafford Michelle, Dougherty Michelle, Teachout Emily, Haynes Shakia B
Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States.
NORC at the University of Chicago, Chicago, IL, United States.
Prev Med Rep. 2023 Jun 5;34:102271. doi: 10.1016/j.pmedr.2023.102271. eCollection 2023 Aug.
The objective of this study was to examine effectiveness of a Hypertension Management Program (HMP) in a Federally Qualified Health Center (FQHC). From September 2018 through December 2019, we implemented HMP in seven clinics of an FQHC in rural South Carolina. A pre/post evaluation design estimated the association of HMP with hypertension control rates and systolic blood pressure using electronic health record data among 3,941 patients. A chi-square test estimated change in mean control rates in pre- and intervention periods. A multilevel multivariable logistic regression model estimated the incremental impact of HMP on odds of hypertension control. Results showed that 53.4% of patients had controlled hypertension pre-intervention (September 2016-September 2018); 57.3% had controlled hypertension at the end of the observed implementation period (September 2018-December 2019) (p < 0.01). Statistically significant increases in hypertension control rates were observed in six of seven clinics (p < 0.05). Odds of controlled hypertension were 1.21 times higher during the intervention period compared to pre-intervention (p < 0.0001). Findings can inform the replication of HMP in FQHCs and similar health care settings, which play a pivotal role in caring for patients with health and socioeconomic disparities.
本研究的目的是检验高血压管理项目(HMP)在联邦合格健康中心(FQHC)的有效性。从2018年9月至2019年12月,我们在南卡罗来纳州农村地区一家FQHC的七家诊所实施了HMP。采用前后评估设计,利用3941例患者的电子健康记录数据评估HMP与高血压控制率及收缩压之间的关联。采用卡方检验估计干预前和干预期间平均控制率的变化。采用多水平多变量逻辑回归模型估计HMP对高血压控制几率的增量影响。结果显示,53.4%的患者在干预前(2016年9月至2018年9月)高血压得到控制;在观察到的实施期结束时(2018年9月至2019年12月),57.3%的患者高血压得到控制(p<0.01)。在七家诊所中的六家观察到高血压控制率有统计学意义的提高(p<0.05)。与干预前相比,干预期间高血压得到控制的几率高出1.21倍(p<0.0001)。研究结果可为FQHC及类似医疗保健机构中HMP的推广提供参考,这些机构在照顾有健康和社会经济差异的患者方面发挥着关键作用。