Jerilyn K. Allen|Cheryl Dennison Himmelfarb|Sarah L. Szanton|Lee Bone|Martha N. Hill|David M. Levine|Murray West|Aaron Barlow|LaPricia Lewis-Boyér|Mary Donnelly-Strozzo|Carol Curtis|Katherine Anderson
Community Outreach and Cardiovascular Health (COACH) Trial
Johns Hopkins University|Baltimore Medical System|Baltimore Medical System|Johns Hopkins University|Baltimore Medical System|Johns Hopkins University|Baltimore Medical System|Johns Hopkins University|Baltimore Medical System|Johns Hopkins University|Baltimore Medical System|Johns Hopkins University|Baltimore Medical System|Johns Hopkins University|Baltimore Medical System|Johns Hopkins University|Baltimore Medical System|Johns Hopkins University|Baltimore Medical System|Johns Hopkins University|Baltimore Medical System|Johns Hopkins University|Johns Hopkins University|Baltimore Medical System
despite wellpublicized guidelines appropriate management cardiovascular disease type 2 diabetes implementation riskreducing practices remains poor report describes results randomized controlled clinical trial evaluating effectiveness comprehensive program cardiovascular disease risk reduction delivered nurse practitioner community health worker npchw teams versus enhanced usual care euc improve lipids blood pressure glycated hemoglobin hba1c patient perceptions quality chronic illness care patients urban community health centersa total 525 patients documented cardiovascular disease type 2 diabetes hypercholesterolemia hypertension levels ldl cholesterol blood pressure hba1c exceeded goals established national guidelines randomly assigned npchw n261 euc n264 groups npchw intervention included aggressive pharmacological management tailored educational behavioral counseling lifestyle modification problem solving address barriers adherence control compared euc patients npchw group significantly greater 12month improvement total cholesterol difference 197 mgdl ldl cholesterol difference159 mgdl triglycerides difference 163 mgdl systolic blood pressure difference 62 mm hg diastolic blood pressure difference 31 mm hg hba1c difference 05 perceptions quality chronic illness care difference 12 pointsan intervention delivered npchw team using individualized treatment regimens based treattotarget algorithms effective approach improve risk factor status perceptions chronic illness care highrisk patients