Please use this identifier to cite or link to this item:
https://doi.org/10.1186/1745-6215-10-13
DC Field | Value | |
---|---|---|
dc.title | Hypertension Improvement Project (HIP): Study protocol and implementation challenges | |
dc.contributor.author | Dolor, R.J | |
dc.contributor.author | Yancy Jr | |
dc.contributor.author | Owen, W.F | |
dc.contributor.author | Matchar, D.B | |
dc.contributor.author | Samsa, G.P | |
dc.contributor.author | Pollak, K.I | |
dc.contributor.author | Lin, P.-H | |
dc.contributor.author | Ard, J.D | |
dc.contributor.author | Prempeh, M | |
dc.contributor.author | McGuire, H.L | |
dc.contributor.author | Batch, B.C | |
dc.contributor.author | Fan, W | |
dc.contributor.author | Svetkey, L.P | |
dc.date.accessioned | 2020-10-20T08:26:12Z | |
dc.date.available | 2020-10-20T08:26:12Z | |
dc.date.issued | 2009 | |
dc.identifier.citation | Dolor, R.J, Yancy Jr, Owen, W.F, Matchar, D.B, Samsa, G.P, Pollak, K.I, Lin, P.-H, Ard, J.D, Prempeh, M, McGuire, H.L, Batch, B.C, Fan, W, Svetkey, L.P (2009). Hypertension Improvement Project (HIP): Study protocol and implementation challenges. Trials 10 : 13. ScholarBank@NUS Repository. https://doi.org/10.1186/1745-6215-10-13 | |
dc.identifier.issn | 1745-6215 | |
dc.identifier.uri | https://scholarbank.nus.edu.sg/handle/10635/178227 | |
dc.description.abstract | Background: Hypertension affects 29% of the adult U.S. population and is a leading cause of heart disease, stroke, and kidney failure. Despite numerous effective treatments, only 53% of people with hypertension are at goal blood pressure. The chronic care model suggests that blood pressure control can be achieved by improving how patients and physicians address patient self-care. Methods and design: This paper describes the protocol of a nested 2 × 2 randomized controlled trial to test the separate and combined effects on systolic blood pressure of a behavioral intervention for patients and a quality improvement-type intervention for physicians. Primary care practices were randomly assigned to the physician intervention or to the physician control condition. Physician randomization occurred at the clinic level. The physician intervention included training and performance monitoring. The training comprised 2 internet-based modules detailing both the JNC-7 hypertension guidelines and lifestyle modifications for hypertension. Performance data were collected for 18 months, and feedback was provided to physicians every 3 months. Patient participants in both intervention and control clinics were individually randomized to the patient intervention or to usual care. The patient intervention consisted of a 6-month behavioral intervention conducted by trained interventionists in 20 group sessions, followed by 12 monthly phone contacts by community health advisors. Follow-up measurements were performed at 6 and 18 months. The primary outcome was the mean change in systolic blood pressure at 6 months. Secondary outcomes were diastolic blood pressure and the proportion of patients with adequate blood pressure control at 6 and 18 months. Discussion: Overall, 8 practices (4 per treatment group), 32 physicians (4 per practice; 16 per treatment group), and 574 patients (289 control and 285 intervention) were enrolled. Baseline characteristics of patients and providers and the challenges faced during study implementation are presented. The HIP interventions may improve blood pressure control and lower cardiovascular disease risk in a primary care practice setting by addressing key components of the chronic care model. The study design allows an assessment of the effectiveness and cost of physician and patient interventions separately, so that health care organizations can make informed decisions about implementation of 1 or both interventions in the context of local resources. © 2009 Dolor et al; licensee BioMed Central Ltd. | |
dc.publisher | BMC | |
dc.rights | Attribution 4.0 International | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.source | Unpaywall 20201031 | |
dc.subject | adult | |
dc.subject | article | |
dc.subject | behavior therapy | |
dc.subject | blood pressure regulation | |
dc.subject | clinical protocol | |
dc.subject | clinical trial | |
dc.subject | controlled clinical trial | |
dc.subject | controlled study | |
dc.subject | cost benefit analysis | |
dc.subject | diastolic blood pressure | |
dc.subject | female | |
dc.subject | health program | |
dc.subject | human | |
dc.subject | hypertension | |
dc.subject | intervention study | |
dc.subject | lifestyle modification | |
dc.subject | major clinical study | |
dc.subject | male | |
dc.subject | medical practice | |
dc.subject | outcome assessment | |
dc.subject | randomized controlled trial | |
dc.subject | systolic blood pressure | |
dc.subject | treatment response | |
dc.subject | attitude to health | |
dc.subject | blood pressure | |
dc.subject | chronic disease | |
dc.subject | clinical competence | |
dc.subject | clinical practice | |
dc.subject | clinical protocol | |
dc.subject | diet | |
dc.subject | economics | |
dc.subject | exercise | |
dc.subject | health personnel attitude | |
dc.subject | methodology | |
dc.subject | multimodality cancer therapy | |
dc.subject | pathophysiology | |
dc.subject | patient compliance | |
dc.subject | patient education | |
dc.subject | practice guideline | |
dc.subject | psychological aspect | |
dc.subject | risk reduction | |
dc.subject | time | |
dc.subject | treatment outcome | |
dc.subject | antihypertensive agent | |
dc.subject | Antihypertensive Agents | |
dc.subject | Attitude of Health Personnel | |
dc.subject | Blood Pressure | |
dc.subject | Chronic Disease | |
dc.subject | Clinical Competence | |
dc.subject | Clinical Protocols | |
dc.subject | Combined Modality Therapy | |
dc.subject | Cost-Benefit Analysis | |
dc.subject | Diet | |
dc.subject | Exercise | |
dc.subject | Guideline Adherence | |
dc.subject | Health Knowledge, Attitudes, Practice | |
dc.subject | Humans | |
dc.subject | Hypertension | |
dc.subject | Patient Compliance | |
dc.subject | Patient Education as Topic | |
dc.subject | Physician's Practice Patterns | |
dc.subject | Practice Guidelines as Topic | |
dc.subject | Research Design | |
dc.subject | Risk Reduction Behavior | |
dc.subject | Time Factors | |
dc.subject | Treatment Outcome | |
dc.type | Article | |
dc.contributor.department | DUKE-NUS MEDICAL SCHOOL | |
dc.description.doi | 10.1186/1745-6215-10-13 | |
dc.description.sourcetitle | Trials | |
dc.description.volume | 10 | |
dc.description.page | 13 | |
dc.published.state | published | |
Appears in Collections: | Staff Publications Elements |
Show simple item record
Files in This Item:
File | Description | Size | Format | Access Settings | Version | |
---|---|---|---|---|---|---|
10_1186_1745-6215-10-13.pdf | 348.16 kB | Adobe PDF | OPEN | None | View/Download |
This item is licensed under a Creative Commons License