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首页> 外文期刊>The journal of clinical hypertension. >Reducing Clinical Inertia in Hypertension Treatment: A Pragmatic Randomized Controlled Trial
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Reducing Clinical Inertia in Hypertension Treatment: A Pragmatic Randomized Controlled Trial

机译：降低高血压治疗中的临床惯性：一种实用的随机对照试验

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Clinical inertia is a major contributor to poor blood pressure (BP) control. The authors tested the effectiveness of an intervention targeting physician, patient, and office system factors with regard to outcomes of clinical inertia and BP control. A total of 591 adult primary care patients with elevated BP (mean systolic BP ≥140mm Hg or mean diastolic BP ≥90mm Hg) were randomized to intervention or usual care. An outreach coordinator raised patient and provider awareness of unmet BP goals, arranged BP-focused primary care clinic visits, and furnished providers with treatment decision support. The intervention reduced clinical inertia (-29% vs -11%, P=.001). Nonetheless, change in BP did not differ between intervention and usual care (-10.1/-4.1mm Hg vs -9.1/-4.5mm Hg, P=.50 and 0.71 for systolic and diastolic BP, respectively). Future primary care-focused interventions might benefit from the use of specific medication titration protocols, treatment adherence support, and more sustained patient follow-up visits.
机译：临床惯性是导致不良血压（BP）控制的主要因素。作者测试了针对医师，患者和办公室系统因素的干预措施在临床惯性和血压控制方面的有效性。总共591例BP升高（平均收缩压≥140mm Hg或平均舒张压BP≥90mm Hg）的成年初级护理患者被随机分为干预或常规治疗。一名外展协调员提高了患者和医疗服务提供者对未达到BP目标的认识，安排了以BP为重点的初级保健诊所就诊，并为医疗服务提供者提供了治疗决策支持。干预减少了临床惯性（-29％vs -11％，P = .001）。尽管如此，介入治疗和常规护理之间的血压变化无差异（收缩压和舒张压分别为-10.1 / -4.1mm Hg和-9.1 / -4.5mm Hg，P = .50和0.71）。未来以初级保健为重点的干预措施可能会受益于特定药物滴定方案的使用，治疗依从性的支持以及对患者的持续随访。

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