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Measure Accurately Act Rapidly and Partner With Patients (MAP) improves hypertension control in medically underserved patients: Care Coordination Institute and American Medical Association Hypertension Control Project Pilot Study results

机译:准确测量迅速采取行动并与患者合作(MAP)改善医疗不足患者的高血压控制:护理协调研究所和美国医学协会高血压控制项目试点研究结果

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摘要

Measure Accurately, Act Rapidly, and Partner With Patients (MAP) is an evidence‐based protocol implemented to improve hypertension control in a clinic for underserved patients (49.9% Medicaid and 50.2% black). Patients with hypertension seen during the year before intervention and with at least one visit during the 6‐month intervention (N = 714) were included. If initial attended blood pressure (BP; standard aneroid manometer) was ≥140/≥90 mm Hg, unattended automated office BP was measured in triplicate and averaged (Measure Accurately) using an Omron HEM‐907XL. When automated office BP was ≥140/≥90 mm Hg, Act Rapidly included intensification of antihypertensive medications, assessed by therapeutic inertia. Partner With Patients included BP self‐monitoring, reducing pill burden, and minimizing medication costs, which was assessed by systolic BP change per therapeutic intensification. Between baseline and the last study visit, BP control to <140/<90 mm Hg increased from 61.2% to 89.9% (P < .0001). MAP rapidly and significantly improved hypertension control in medically underserved patients, largely as a result of measuring BP accurately and partnering with patients.
机译:准确测量,迅速行动并与患者合作(MAP)是一项循证医学方案,旨在改善服务不足的诊所(49.9%的医疗补助和50.2%的黑人)的高血压控制。包括在干预前一年内观察到的高血压患者,以及在6个月干预期间至少访视一次的患者(N = 714)。如果最初的主诊血压(BP;标准无液血压计)≥140/≥90mm Hg,则一式三份测量无人值守的自动办公室BP,并使用Omron HEM-907XL进行平均(准确测量)。当自动办公室血压≥140/≥90mm Hg时,迅速采取行动,包括根据治疗惯性评估降压药物的强度。与患者的合作伙伴包括BP自我监测,减轻药丸负担并最大程度降低用药成本,这是根据每次治疗强度的收缩压变化来评估的。在基线和最后一次研究访问之间,血压控制在<140 / <90 mm Hg,从61.2%增加到89.9%(P <.0001)。 MAP快速有效地改善了医疗不足患者的高血压控制,这主要是由于准确测量了BP并与患者合作所致。

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