| Title |
Management of hypertension and multiple risk factors to enhance cardiovascular health - a feasibility study in Singapore polyclinics
|
|---|---|
| Published in |
BMC Health Services Research, July 2016
|
| DOI | 10.1186/s12913-016-1491-6 |
| Pubmed ID | |
| Authors |
Tazeen H. Jafar, Ngiap C. Tan, John C. Allen, Shreyasee S. Pradhan, Paul Goh, Saeideh Tavajoh, Fong M. Keng, Jason Chan |
| Abstract |
High blood pressure (BP) is a leading contributor to cardiovascular mortality globally. There is scarcity of information on effective health systems interventions to lower BP and reduce cardiovascular risk in Southeast Asian countries. We conducted a pilot exploratory trial on 100 adults aged 40 years or older with uncontrolled hypertension to optimize the design for a structured multi-component intervention in primary care clinics for management of hypertension. Two clinics were involved, each enrolling 50 participants, with one as the intervention clinic and the other as the control (usual care). The intervention comprised the following four components: 1) an algorithm-driven intervention using a fixed-dose combination (FDC) antihypertensive treatment and lipid lowering medication for high risk individuals, 2) subsidized FDC antihypertensive medication; 3) motivational conversation (MC) for high risk individuals; and 4) telephone follow-ups of all individuals. The process outcomes were intervention fidelity measures. The outcomes of change in parameters of interest were healthy lifestyle index (composite score of body mass index, physical activity, dietary habit, dietary quality and smoking), adherence to antihypertensive medications, and systolic and diastolic BP from baseline to follow-up at 3 months. Greater than 90 % fidelity was achieved for 3 of the 4 intervention components. Although not designed for conclusive results, the healthy lifestyle score increased by 0.16 (±0.68) with the intervention and decreased by 0.18 (±0.75) with usual care (p = 0.02). Adherence to anti-hypertensive medications at follow-up was 95.3 % in the intervention group compared to 83.8 % for usual care (p = 0.01). Systolic and diastolic BP decreased in both intervention and control groups, although statistical significance between groups was not achieved. Hypertensive individuals rated all intervention components 'highly favorable' on a Likert scale. Our findings indicate that the proposed, structured multi-component approach for management of hypertension is feasible for implementation in primary care clinics in Singapore, with some changes to the protocol. The observed improvement in the healthy lifestyle index and adherence to anti-hypertensive medications is promising. A large scale, adequately powered trial would be informative to assess intervention effectiveness on BP and cardiovascular risk reduction. This trial has been registered at ClinicalTrials.gov. ClinicalTrials.gov number NCT02330224 . Registered on 28 December 2014. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 130 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Netherlands | 1 | <1% |
| Unknown | 129 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 19 | 15% |
| Researcher | 15 | 12% |
| Student > Bachelor | 12 | 9% |
| Student > Postgraduate | 9 | 7% |
| Student > Ph. D. Student | 7 | 5% |
| Other | 22 | 17% |
| Unknown | 46 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 30 | 23% |
| Nursing and Health Professions | 18 | 14% |
| Pharmacology, Toxicology and Pharmaceutical Science | 5 | 4% |
| Agricultural and Biological Sciences | 4 | 3% |
| Sports and Recreations | 3 | 2% |
| Other | 15 | 12% |
| Unknown | 55 | 42% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 July 2016.
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#15,379,760
of 22,880,230 outputs
Outputs from BMC Health Services Research
#5,574
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Outputs of similar age
#226,023
of 354,871 outputs
Outputs of similar age from BMC Health Services Research
#134
of 178 outputs
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