Journal Articles

Check It, Change It: A Community-Based, Multifaceted Intervention to Improve Blood Pressure Control.

October 28, 2014

Check It, Change It: A Community-Based, Multifaceted Intervention to Improve Blood Pressure Control. Circ Cardiovasc Qual Outcomes. 2014 Oct 28, Thomas KL1, Shah BR2, Elliot-Bynum S2, Thomas KD2, Damon K2, Allen LaPointe NM2, Calhoun S2, Thomas L2, Breathett K2, Mathews R2, Anderson M2,Califf RM2, Peterson ED2.

  • 1From the Department of Medicine, Duke University, Durham, NC (K.L.T., B.R.S., R.M., M.A., R.M.C., E.D.P.); Duke Clinical Research Institute, Durham, NC (K.L.T., B.R.S., K.D.T., N.M.A.L., S.C., L.T., R.M., M.A., R.M.C., E.D.P.); Healing with CAARE, Inc, Durham, NC (S. E.-B., K.D.); Duke Translational Medicine Institute, Durham, NC (R.M.C.); Department of Medicine, Ohio State University, Columbus, OH (K.B.). kevin.thomas@duke.edu.
  • 2From the Department of Medicine, Duke University, Durham, NC (K.L.T., B.R.S., R.M., M.A., R.M.C., E.D.P.); Duke Clinical Research Institute, Durham, NC (K.L.T., B.R.S., K.D.T., N.M.A.L., S.C., L.T., R.M., M.A., R.M.C., E.D.P.); Healing with CAARE, Inc, Durham, NC (S. E.-B., K.D.); Duke Translational Medicine Institute, Durham, NC (R.M.C.); Department of Medicine, Ohio State University, Columbus, OH (K.B.).

Abstract

BACKGROUND:

Although home blood pressure (BP) monitoring interventions have shown potential in selected populations, it is unclear whether such strategies can be generalized. We sought to determine whether a multifaceted BP control program that uses a web-based health portal (Heart360), community health coaches, and physician assistant guidance could improve hypertension control in a diverse community setting.

METHODS AND RESULTS:

Between September 12, 2010, and November 11, 2011 Check It, Change It, a community-based hypertension quality improvement program, enrolled 1756 patients with hypertension from 8 clinics in Durham County, NC. The Check It, Change It communityintervention was evaluated using a prepost study design without a concurrent control. Participants were stratified into 3 tiers according to their initial BP: tier 0 (BP <140/90 mm Hg)=51% of population, tier 1 (BP=140/90-159/99 mm Hg)=30% of total, and tier 2 (BP ≥159/99 mm Hg)=19% of total. Overall, median age was 59 years (interquartile range, 49-69), 67% were female, and 76% black. After 6 months, the mean overall systolic BP declined 4.7 mm Hg. Rates of achieving target BP control (<140/90) increased overall from 51% at baseline to 63% by 6 months, and 69% had either reached their BP target or had reduced their baseline systolic BP by 10 mm Hg or more.

CONCLUSIONS:

A multicomponent-tiered hypertension program was associated with improved BP control in a diverse community-based population.

© 2014 American Heart Association, Inc.

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