Nessman D G, Carnahan J E, Nugent C A
Arch Intern Med. 1980 Nov;140(11):1427-30. doi: 10.1001/archinte.140.11.1427.
Compliance was compared in 52 previously noncompliant hypertensive patients randomly assigned for eight weeks to either a nurse-operated hypertension clinic (control) or a patient-operated hypertension group] (experimental). Control patients listened to audiotapes on hypertension and its management and met individually with a nurse who adjusted their drug regimens. Experimental patients were trained to take their own blood pressure (BP) and select their own drugs in a group program emphasizing informed self-help. After the eight-week training period and at two- and six-month follow-up visits, both groups had significantly lower BPs. Compared with control patients, experimental patients had lower diastolic BPs, better pill counts, and better attendance (all P < .05). This study suggests that training noncompliant patients in groups to manage their own hypertension may achieve better results than traditional management programs.
对52名既往血压控制不佳的高血压患者进行了依从性比较，这些患者被随机分配，接受为期8周的治疗，其中一组为护士主导的高血压诊所治疗（对照组），另一组为患者主导的高血压治疗组（试验组）。对照组患者收听有关高血压及其管理的录音带，并与调整其药物治疗方案的护士单独会面。试验组患者在一个强调自主知情的小组项目中接受培训，自行测量血压并选择自己的药物。在为期8周的训练期结束后，以及在2个月和6个月的随访中，两组患者的血压均显著降低。与对照组患者相比，试验组患者的舒张压更低，服药依从性更好，就诊率更高（所有P值均<0.05）。这项研究表明，对血压控制不佳的患者进行小组培训以管理自身高血压，可能比传统管理方案取得更好的效果。
