• 作者：Emilio Má ; rquez Contreras^a ; ^{emarquezc@papps.org} ; Nieves Martel Claros^b ; Vicente Gil Guillé ; n^c ; José ; Luis Martí ; n De Pablos^a ; Mariano De La Figuera Von Wichman^d ; José ; Joaquin Casado Martí ; nez^a ; Jacinto Espinosa Garcí ; a^e
• 关键词：Hipertensió ; n arterial ; Inercia terap&eacute ; utica ; Ensayo clí ; nico
• 刊名：Atenci贸n Primaria
• 出版年：2009
• 期刊代码：pca69_02126567
• 类别：med
• 出版时间：June 2009
• 卷：41
• 期：6
• 页码：315-323
• 文件大小：427 K

Objective

To evaluate the efficacy of different interventions on therapeutic Inertia (TI) in mild-to-moderate hypertension (AHT).

Design

Controlled, randomised clinical trial.

Setting

Two hundred clinics in 5 primary care centres. Spain.

Participants

A total of 1104 patients with uncontrolled hypertension were included.

Intervention

Four groups with 276 patients were formed: 1) Control group (CG): standard health intervention; 2) Education intervention and a program of home blood pressure monitoring (HBPM) (EG); 3) Card control intervention and HBPM programme (CHG); 4) Education intervention, card control and HBPM programme (ECHG).

Main measurements

TI was calculated by the rate: (Number of patients whose pharmacological treatment was not changed in each visit/Number of patients with an average BP 猢?40 mmHg and/or 猢?0 mmHg in the general population or 猢?30 and/or 90 mmHg in diabetics). The mean BPs and the percentage of controlled patients were calculated. The mean number of people that required an intervention in order to avoid TI was calculated (NI).

Results

A total of 921 patients completed the study, and 1842 visits were made, with TI in 36.8%(IC=5.8%) of the sample and in 82.58%(IC=8.2%) of the uncontrolled hypertensive patients. The TI was 60%(CI=4.2%), 38.4%(CI=4.4%) 30.2 (CI=4.3%) and 14.7 (CI=3.3%) (p=0.001) for CG, EG, CHG and ECHG, respectively. The percentage controlled at the end of study was 35.3%(CI=1.1%), 54.7%(CI=1.8%), 60.2%(CI=2.1%) and 65.1%(CI=2.2%) (p<0.01) for CG, EG, CHG and ECHG, respectively. The NI were 4.6, 3.3 and 2.2 for CG, EG, CHG and ECHG, respectively.

Conclusions

TI was very significant among the uncontrolled hypertensive patients. The studied interventions are effective for improving TI.