Matthew L. Maciejewski|Hayden B. Bosworth|Maren K. Olsen|Valerie A. Smith|David Edelman|Benjamin Powers|Miriam A. Kaufman|Eugene Ž. Oddone|George L. Jackson
Do the Benefits of Participation in a Hypertension Self-Management Trial Persist After Patients Resume Usual Care?
Duke University|Duke University|Duke University|Duke University|Duke University|Duke University|Duke University|Duke University|Duke University
hypertension selfmanagement shown improve systolic blood pressure bp control longerterm economic clinical impacts unknown purpose article examine clinical economic outcomes 18 months completion hypertension selfmanagement trialthis study followup analysis 18month 4arm hypertension selfmanagement trial 591 veterans hypertension randomized usual care 1 3 interventions clinicderived systolic blood pressure obtained trial estimated using linear mixed models inpatient admissions outpatient expenditures total expenditures estimated using generalized estimating equations 3 telephonebased interventions nurseadministered health behavior promotion provideradministered medication adjustments based hypertension treatment guidelines combination intervention calls triggered home bp values transmitted via telemonitoring devices clinical economic outcomes examined 12 months 18 months 18 months trial completion compared usual care patients randomized combined arm greater improvement proportion bp control 18month trial estimated proportion bp control improved 18 months trial completion patients behavioral medication management arms among patients inadequate baseline bp control estimated mean systolic bp significantly lower combined arm compared usual care 18month trial utilization expenditure trends similar patients 4 armsbehavioral medication management generate systolic bp improvements sustained 18 months trial completionurl httpwwwclinicaltrialsgov unique identifier nct00237692