Scakacs J, Ackers I, Rodriguez J, Ojong-Egbe O, Casapulla S. Effectiveness of Home Blood Pressure Monitoring Among Low-Income Adults in Rural Appalachia. J Am Osteopath Assoc 2016;116(5):288–294. doi: https://doi.org/10.7556/jaoa.2016.058.
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Context: High blood pressure (BP) is a common chronic condition in the United States. For many people, BP control through pharmacologic intervention alone is not effective at maintaining a healthy BP. Team-based, patient-focused care and home-based BP monitoring in addition to pharmacologic interventions have been shown to be effective for controlling BP.
Objective: To determine the effectiveness of the hypertension management program at the Heritage Community Clinic in Athens, Ohio.
Methods: Medical records of 43 patients who took part in the hypertension management program were retrospectively reviewed and included clinical data such as age, sex, BP, body mass index, comorbidities, family history, and demographic information. In addition to standard pharmacologic interventions, the program provided equipment for at-home BP monitoring, education on behavior and lifestyle modification, and 5 follow-up visits. Data from the 5 follow-up visits were analyzed.
Results: Linear mixed-effects regression models of BP suggested that the visit factor was significantly associated with BP (P<.001). On average at each visit, patients showed a 6.8–mm Hg reduction in systolic BP and a 3.8–mm Hg reduction in diastolic BP after controlling for demographic variables. General stress level, marital status, and depression were all significantly associated with BP (P<.05). In addition, 67.5% of the patients who took part in this program achieved the target treatment guidelines of the Eighth Joint National Committee for hypertension management.
Conclusion: A clinic-based hypertension management program comprising patient education, support, medication, and home BP monitoring was effective at reducing BP.
a Data are presented as β (SE) except where otherwise noted. Model 1 included the visit factor and basic demographic variables (ie, body mass index, sex, age, and education level). Model 2 additionally included general stress levels, marital status, anxiety, depression, high cholesterol, diabetes mellitus, and family histories of heart disease and hypertension.
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