TY - JOUR
T1 - Check it, change it
T2 - A community-based, multifaceted intervention to improve blood pressure control
AU - Thomas, Kevin L.
AU - Shah, Bimal R.
AU - Elliot-Bynum, Sharon
AU - Thomas, Kristin D.
AU - Damon, Katrina
AU - LaPointe, Nancy M.Allen
AU - Calhoun, Sarah
AU - Thomas, Laine
AU - Breathett, Khadijah
AU - Mathews, Robin
AU - Anderson, Monique
AU - Califf, Robert M.
AU - Peterson, Eric D.
N1 - Publisher Copyright:
© 2014 American Heart Association, Inc.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - 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 community intervention 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.
AB - 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 community intervention 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.
KW - Blood pressure
KW - Hypertension
KW - Quality improvement
KW - Self blood pressure monitoring
KW - residence characteristics
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U2 - 10.1161/CIRCOUTCOMES.114.001039
DO - 10.1161/CIRCOUTCOMES.114.001039
M3 - Article
C2 - 25351480
AN - SCOPUS:84925875073
SN - 1941-7713
VL - 7
SP - 828
EP - 834
JO - Circulation: Cardiovascular Quality and Outcomes
JF - Circulation: Cardiovascular Quality and Outcomes
IS - 6
ER -