***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background and Purpose — High rates of ischemic stroke and poor adherence to secondary prevention measures are observed in the Chinese population . Methods — We used a national , multicenter , cluster-r and omized controlled trial in which 47 hospitals were r and omized to either a  structured care program group ( n=23 ) or a usual care group ( n=24 ) . The structured care program consisted of a specialist-administered , guideline -recommended pharmaceutical treatment and a lifestyle modification algorithm associated with written and Internet-accessed educational material for patients for the secondary prevention of ischemic stroke . The primary efficacy outcome was the proportion of patients who adhered to the recommended measures at 12-month postdischarge . This trial is registered with Clinical Trial.gov ( NCT00664846 ) . Results — At 12 months , 1287 ( 72.1 % ) patients in the St and ard Medical Management in Secondary Prevention of Ischemic Stroke in China ( SMART ) group and 1430 ( 72 % ) patients in the usual care group had completed the 12-month follow-up ( P=0.342 ) . Compared with the usual care group , those in the SMART group showed higher adherence to statins ( 56 % versus 33 % ; P=0.006 ) but no difference in adherence to antiplatelet ( 81 % versus 75 % ; P=0.088 ) , antihypertensive ( 67 % versus 69 % ; P=0.661 ) , or diabetes mellitus drugs ( 73 % versus 67 % ; P=0.297 ) . No significant difference in the composite end point ( new-onset ischemic stroke , hemorrhagic stroke , acute coronary syndrome , and all-cause death ) was observed ( 3.56 % versus 3.59 % ; P=0.921 ) . Conclusions — The implementation of a program to improve adherence to secondary ischemic stroke prevention efforts in China is feasible , but these programs had only a limited impact on adherence and no impact on 1-year outcomes . Further development of a structured program to reduce vascular events after stroke is needed . Clinical Trial Registration — URL : http://www . clinical trials.gov . Unique identifier : NCT00664846 Background Community-based health education programs may be helpful in improving health outcomes in patients with chronic illnesses . This study aim ed to evaluate community-based health education strategies in the management of hypertensive patients with low socioeconomic status in Dongguan City , China . Methods This was a r and omized , non-blinded trial involving 360 hypertensive patients enrolled in the community health service centre of Liaobu Town , Dongguan City , China . Participants were r and omized to receive one of the three community-based health education programs  over 2 years : self-learning reading ( Group 1 ) , monthly regular didactic lecture ( Group 2 ) , monthly interactive education workshop ( Group 3 ) . Outcomes included the changes in the proportion of subjects with normalized blood pressure ( BP ) , hypertension-related knowledge score , adherence to antihypertensive treatment , lifestyle , body mass index and serum lipids . Results After the 2-y intervention , the proportion of subjects with normalized BP increased significantly in Group 2 ( from 41.2 % to 63.2 % , p<0.001 ) , and increased more substantially in Group 3 ( from 40.2 % to 86.3 % , p<0.001 ) , but did not change significantly in Group 1 . Improvements in hypertension-related knowledge score , adherence to regular use of medications , appropriate salt intake and regular physical activity were progressively greater from group 1 to group 2 to group 3 . Group 3 had the largest reductions in body mass index and serum LDL cholesterol levels . Conclusion Interactive education workshops may be the most effective strategy in community-based health promotion education programs for hypertensive patients in improving patients ’ knowledge on hypertension and alleviating clinical risk factors for preventing hypertension-related complications Limited data are available on epidemiology and drug use in Chinese hypertensive patients with chronic kidney disease ( CKD ) . We determined the prevalence ; awareness , treatment , and control rates of hypertension ; anti-hypertensive use , expenditure pattern ; and factors associated with hypertension prevalence and control in Chinese patients with CKD . This was one of the largest cross-sectional surveys that enrolled 6079 CKD participants ( mean age , 51.0 ± 16.37 years ) with or without hypertension from 22 centres across China .  The prevalence , awareness , and treatment rates were 71.2 % , 95.4 % , and 93.7 % , respectively . Control rates 1 and 2 ( Blood pressure , BP < 140/90 and < 130/80 mmHg ) were 41.1 % and 15.0 % , respectively . Patients were treated mostly with monotherapy ( 37.7 % ) or 2-drug anti-hypertensive combination ( 38.7 % ) . Factors associated with prevalence of hypertension included age ; smoking ; body mass index ; physical exercise ; family history of hypertension ; hyperuricaemia ; and CKD . Control rate was associated with CKD stage , BP monitoring at home , and use of drug combinations . Despite high rates of awareness and treatment , the control rates are low . CKD stages 4 and 5 adversely affect the control rate . The results suggest the immediate need of comprehensive controlling measures to improve the control of hypertension in Chinese patients with CKD This study aims to develop a nurse-led hypertension management model in the community setting and pilot it to an experimental trial . A total of 73 recruited participants were r and omly allocated into two groups . The study group received a home visit and 2 - 4 telephone follow-ups from the trained community nurses assisted by nursing student volunteers . The control group received doctor-led hypertension management . Data was collected at recruitment and immediately after the 8-week program . Outcome measures included blood pressure readings , self-care adherence , self-efficacy , quality of life , and patient satisfaction . Participants from the study group led by nurses had significant improvement in self-care adherence , patient satisfaction post-intervention than those from the control group led by doctors . However , there were no statistical significant differences in blood pressure readings , quality of life and self-efficacy between the two groups . The findings show that the nurse-led hypertension management appears to be a promising way to manage hypertensive patients at the community level , particularly when the healthcare system is better integrated BACKGROUND The prevalence of hypertension is high , but the overall control rate is low . Poor control of , hypertension is associated with a number of diseases , such as stroke , heart and renal failure , and high , mortality rates . Studies have shown the separate effects of nurse clinics and telephone follow-up on , blood pressure control , but the incremental effect of combining the two interventions is unknown . OBJECTIVES This study examines whether there is an incremental effect on blood pressure control when using a  nurse clinic combined with telephone follow-up . METHODS This was a r and omised controlled trial . The primary outcome measure was blood pressure reading . The secondary outcome measures included adherence to home blood pressure monitoring , exercise , diet , medication , and satisfaction with care . RESULTS There were no significant differences in the baseline measures between the control and study groups . Significant differences were found at 8 weeks after intervention was initiated between groups in , systolic blood pressure ( control -7.97 vs study -19.03 , t=2.35 , p=0.022 , CI 1.66 - 20.47 ) and diastolic , blood pressure ( control -3.72 vs study -11.68 , t=3.02 , p=0.004 , CI 2.68 - 13.24 ) . Other variables with a significant between-group differences ( p<0.05 ) were blood pressure control rate , adherence , to home blood pressure monitoring , exercise and satisfaction with care . Further analysis using , regression showed that home blood pressure monitoring is the most significant predictor for improved , systolic blood pressure . CONCLUSIONS This study showed that  nurse clinics have positive effects on blood pressure control and adherence to healthy lifestyle , but telephone follow-up after such clinics augments the effects of the clinic consultation . This combined mode of services is worth considering for other chronic disease , management programmes OBJECTIVE This study tests the effectiveness of motivational interviewing compared with the usual care for Chinese hypertensive patients . METHODS A r and omised controlled trial was used . One hundred and twenty eligible participants were r and omly assigned to either the control group ( usual care group ) or the intervention group ( motivational interviewing group ) . RESULTS The results of this study demonstrated that the total scores and the mean scores for each dimension of the adherence question naire were increased in the intervention group ( P<0.05 ) , and the systolic blood pressure and diastolic blood pressure of the hypertensive patients greatly decreased in the intervention group during the six months of the motivational interviewing counselling ( P<0.05 ) . CONCLUSION The application of motivational interviewing for hypertensive patients is a promising approach for sustaining the clinical benefits of adherence behaviour . PRACTICE IMPLICATION S Motivational interviewing should be provided to hypertensive patients at hospitals and community health centres to assist patients in controlling their BP and to enhance treatment adherence . A series of training courses on the motivational interviewing technique should be provided to nurses AIM The aim of this study was to examine the effect of a cardiac rehabilitation programme on health behaviours and physiological risk parameters in patients with coronary heart disease in Chengdu , China . BACKGROUND Epidemiological studies indicate a dose- , level- and duration -dependent relationship exists between cardiac behavioural and physiological risks and coronary heart disease incidence as well as subsequent cardiac morbidity and mortality . Cardiac risk factor modification has become the very primary goal of modern cardiac rehabilitation programmes . DESIGN METHODS A r and omized controlled trial was conducted . Coronary heart disease patients ( n = 167 ) who met the sampling criteria in two tertiary medical centres in Chengdu , south-west China , were r and omly assigned to either an intervention group ( the cardiac rehabilitation programme ) or control group ( the routine care ) . The change of health behaviours ( walking performance , step II diet adherence , medication adherence , smoking cessation ) and physiological risk parameters ( serum lipids , blood pressure , body weight ) were assessed to evaluate the programme effect . RESULTS Patients in the intervention group demonstrated a significantly better performance in walking , step II diet adherence , medication adherence ; a significantly greater reduction in serum lipids including triglyceride , total cholesterol , low-density lipoprotein ; and significantly better control of systolic and diastolic blood pressure at three months . The majority of these positive impacts were maintained at six months . The effect of the programme on smoking cessation , body weight , serum high-density lipoprotein , was not confirmed . CONCLUSIONS A cardiac rehabilitation programme led by a nurse can significantly improve the health behaviours and cardiac physiological risk parameters in coronary heart disease patients . Nurses can fill significant treatment gaps in the risk factor management of patients with coronary heart disease . RELEVANCE TO CLINICAL PRACTICE This study raises attention regarding the important roles nurses can play in cardiac rehabilitation and the unique way for nurses to meet the rehabilitative care needs of coronary heart disease patients . Furthermore , the hospital-home bridging nature of the programme also created a model for interfacing the acute care and community rehabilitative care Adherence to antihypertensive medications represents a crucial success factor for optimal blood pressure ( BP ) control in clinical practice . This study evaluated whether an additional pharmacist-led medication counseling could achieve better optimal BP control and enhance compliance .  In a design ated family clinic in a region with similar resident characteristics to Hong Kong , patients taking ≥ one antihypertensive agent with suboptimal compliance were r and omly allocated to a brief 3-minute drug advice ( control ; n = 161 ) or pharmacist counseling ( intervention ; n = 113 ) . The two groups were compared by repeated measure ANOVA at 3-months and 6-months with BP control and medication compliance as outcome variables , respectively . The proportions of patients having optimal compliance increased from 0 % to 41.1 % at 3 months and 61.9 % at 6 months ( P < 0.001 ) . The proportion of patients having optimal BP control improved from 64.1 % at baseline to 74.0 % at 3 months and 74.5 % at 6 months ( P = 0.023 ) . There were no significant differences between the two groups in the changes of BP control and compliance levels . This study implied that even a brief 3-minute drug advice might lead to improved BP levels  among patients on antihypertensive medications in general practice , but did not demonstrate additional effects by pharmacist counseling Empirical evidence has suggested that social support from family can help patients take their medicines correctly . This study aims to evaluate the role of a family member-based supervision package in the management of hypertension using a cluster r and omized trial in rural China . We recruited patients with hypertension from four villages in Yangzhong and r and omly allocated them to the control group ( n=288 ) and the intervention group ( n=266 ) .  A family member-based supervision package was applied to the intervention group , while the usual service was applied to the controls . Patients were followed for 12 months and completed face-to-face interviews at the end of 6 and 12 months . The primary outcomes were patients ’ medication adherence and frequency of blood pressure measurement . Secondary outcomes included changes in blood pressure , altered risk behaviours and occurrence of hypertension 
    Output:
    
Longer duration of intervention gave better effectiveness .
Physician as interventionist , regular follow-up visits and interventions conducted at a hospital were associated with better effectiveness .
Adherence interventions  improve MA and reduce uncontrolled BP among Chinese patients with hypertension .