Brief provider communication skills training fails to impact patient hypertension outcomes

PATIENT EDUCATION AND COUNSELING

卷:98

Article

Manze, Meredith G.¹  Orner, Michelle B.²  Glickman, Mark^2,3  Pbert, Lori⁴  Berlowitz, Dan^2,3  Kressin, Nancy R.^5,6 

[1] CUNY Hunter Coll, Sch Publ Hlth, New York, NY 10035 USA

[2] Bedford VAMC, Ctr Healthcare Org & Implementat Res, Bedford, MA USA

[3] Boston Univ, Sch Publ Hlth, Hlth Policy & Management Dept, Boston, MA USA

[4] Univ Massachusetts, Sch Med, Worcester, MA USA

[5] VA Boston Healthcare Syst, Boston, MA USA

[6] Boston Univ, Sch Med, Gen Internal Med Sect, Boston, MA 02118 USA

关键词: Hypertension;    Blood pressure;    Patient-provider communication;    Medication adherence;    Patient-centered care;   

DOI  :  10.1016/j.pec.2014.10.014

来源: Elsevier

【 摘 要 】

Objectives: Hypertension remains a prevalent risk factor for cardiovascular disease, and improved medication adherence leads to better blood pressure (BP) control. We sought to improve medication adherence and hypertension outcomes among patients with uncontrolled BP through communication skills training targeting providers. Methods: We conducted a randomized controlled trial to assess the effects of a communication skills intervention for primary care doctors compared to usual care controls, on the outcomes of BP (systolic, diastolic), patient self-reported medication adherence, and provider counseling, assessed at baseline and post-intervention. We enrolled 379 patients with uncontrolled BP; 203 (54%) with follow-up data comprised our final sample. We performed random effects least squares regression analyses to examine whether the provider training improved outcomes, using clinics as the unit of randomization. Results: In neither unadjusted nor multivariate analyses were significant differences in change detected from baseline to follow-up in provider counseling, medication adherence or BP, for the intervention versus control groups. Conclusion: The intervention did not improve the outcomes; it may have been too brief and lacked sufficient practice level changes to impact counseling, adherence or BP. Practice Implications: Future intervention efforts may require more extensive provider training, along with broader systematic changes, to improve patient outcomes. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

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