Effectiveness of a multidisciplinary intervention to improve hypertension control in an urban underserved practice

摘要

Patient-centered, multidisciplinary interventions offer one of the most promising strategies to improve blood pressure (BP) control, yet effectiveness trials in underserved real-world settings are limited. We used a multidisciplinary strategy to improve hypertension control in an underserved urban practice. We collected 1007 surveys to monitor medication adherence and used weighted generalized estimating equations to examine trends in BP control. We examined 13,404 visits from patients with hypertension between August 2010 and February 2014. Overall, BP control rates increased from 51.0% to 67.4% (adjusted odds ratio, 1.58; 95% confidence interval, 1.44-1.74) by the end of the intervention phase and were maintained during the postintervention phase (adjusted odds ratio, 1.60; 95% confidence interval, 1.41-1.82). Medication adherence scores increased across the intervention (5.9-6.6; P <.001), but were not sustained at the conclusion of the study (5.9-6.2; P =.16). A multidisciplinary team approach involving registered nurses, pharmacists, and physicians resulted in substantial improvements in hypertension control in a real-world underserved setting. (c) 2015 American Society of Hypertension. All rights reserved.