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首页> 外文期刊>American Journal of Preventive Medicine >E-care for heart wellness: A feasibility trial to decrease blood pressure and cardiovascular risk
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E-care for heart wellness: A feasibility trial to decrease blood pressure and cardiovascular risk

机译：电子保健以改善心脏健康：一项降低血压和心血管疾病风险的可行性试验

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Background Pharmacist- or nurse-led team care decreases patient blood pressure (BP) and cardiovascular disease (CVD) risk. Purpose To evaluate whether a Web-based dietitian-led (WD) team care intervention was feasible and resulted in decreased BP, CVD risk, and weight compared to usual care (UC). Methods Electronic health record (EHR) data identified patients aged 30-69 years with BMI 26, elevated BP, and 10%-25% 10-year Framingham CVD risk who were registered patient website users. Patients with uncontrolled BP at screening were randomized to UC or WD, which included a home BP monitor, scale, and dietitian team care. WD participants had a single in-person dietitian visit to obtain baseline information and create a plan to reduce CVD risk. Planned follow-up occurred via secure messaging to report BP, weight, and fruit and vegetable intake and receive ongoing feedback. If needed, dietitians encouraged patients and their physicians to intensify antihypertensive and lipid-lowering medications. Primary outcomes were change in systolic BP and weight loss ≥4 kg at 6 months. Feasibility outcomes included intervention utilization and satisfaction. Results Between 2010 and 2011, a total of 90 of 101 participants completed 6-month follow-ups. The WD group had higher rates of secure messaging utilization and patient satisfaction. The WD group lost significantly more weight than the UC group (adjusted net difference=-3.2 kg, 95% CI=-5.0, -1.5, p0.001) and was more likely to lose ≥4 kg (adjusted relative risk [RRadj]=2.96, 95% CI=1.16, 7.53). BP control and CVD risk reduction were greater in WD than UC, but differences were not statistically significant. Conclusions WD intervention was feasible and resulted in decreased weight, BP, and CVD risk. A larger trial is justified. Trial Registration Number Trial Registration Number: NCT01077388.
机译：背景由药剂师或护士主导的团队护理降低了患者的血压（BP）和心血管疾病（CVD）的风险。目的为了评估基于网络的营养师主导（WD）团队护理干预是否可行，并且与常规护理（UC）相比可降低BP，CVD风险和体重。方法电子健康记录（EHR）数据确定了30-69岁的BMI> 26，血压升高和10％-25％的10年Framingham CVD风险的患者，这些患者是注册的网站用户。筛查时血压不受控制的患者被随机分配至UC或WD，其中包括家庭BP监护仪，体重秤和营养师团队护理。 WD参与者进行了一次亲自营养师访问，以获取基线信息并制定降低CVD风险的计划。通过安全的消息传递进行计划的跟进，以报告血压，体重以及水果和蔬菜的摄入量，并获得持续的反馈。如果需要，营养师会鼓励患者及其医生加强降压和降脂药物的治疗。主要结果是6个月时收缩压的变化和体重减轻≥4kg。可行性结果包括干预利用和满意度。结果2010年至2011年，共有101名参与者中的90名完成了6个月的随访。 WD组的安全消息使用率和患者满意度更高。与UC组相比，WD组的体重减轻明显更多（调整后的净差= -3.2 kg，95％CI = -5.0，-1.5，p <0.001），并且更有可能减轻≥4kg（调整后的相对风险[RRadj] = 2.96，95％CI = 1.16，7.53）。 WD的血压控制和CVD风险降低比UC大，但差异无统计学意义。结论WD干预是可行的，并导致体重，血压和CVD风险降低。进行更大的审判是合理的。试用注册号试用注册号：NCT01077388。

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