PDF(Pubmed)
Abstract：
UNASSIGNED: Haiti\'s hypertension prevalence among adults ≥40 years of age is nearly twice that of nations in the Americas. Haiti Health Initiative (HHI) developed a hypertension management protocol for use in outreach clinics in Timo, a rural mountainous community in Haiti. This study aimed to evaluate the effectiveness of the hypertension protocol for treating adults ≥40 years of age and pregnant women with severe hypertension.
UNASSIGNED: This retrospective longitudinal study included 209 patients across 1148 clinic visits/encounters. De-identified medical records from 11 biannual outreach clinics between April 2014 to April 2019 were reviewed for analysis. Descriptive statistics, paired t-tests, and multilevel models were performed. The primary outcome was systolic and diastolic blood pressure measurements at each clinic visit.
UNASSIGNED: In the study (n = 1148 visits), hypertension and severe hypertension prevalence were respectively 79·8% and 38·4%. Multilevel models showed a decrease of 0·29 mmHg (p = 0·37) in systolic blood pressure and a decrease in diastolic blood pressure of 0·66 mmHg (p < 0·001) per visit. Individual factors and protocol adherence did not predict a reduction in blood pressure.
UNASSIGNED: Effective management of hypertension and other chronic conditions among hard-to-reach populations with limited healthcare access requires comprehensive outreach efforts that address care antecedents, structures, and processes. Although outreach clinics made treatment accessible to vulnerable populations, the protocol, which used medications with previously demonstrated efficacy, had little impact on reducing blood pressure in patients with severe hypertension.
UNASSIGNED: This retrospective longitudinal study included 209 patients across 1148 clinic visits/encounters. De-identified medical records from 11 biannual outreach clinics between April 2014 to April 2019 were reviewed for analysis. Descriptive statistics, paired t-tests, and multilevel models were performed. The primary outcome was systolic and diastolic blood pressure measurements at each clinic visit.
UNASSIGNED: In the study (n = 1148 visits), hypertension and severe hypertension prevalence were respectively 79·8% and 38·4%. Multilevel models showed a decrease of 0·29 mmHg (p = 0·37) in systolic blood pressure and a decrease in diastolic blood pressure of 0·66 mmHg (p < 0·001) per visit. Individual factors and protocol adherence did not predict a reduction in blood pressure.
UNASSIGNED: Effective management of hypertension and other chronic conditions among hard-to-reach populations with limited healthcare access requires comprehensive outreach efforts that address care antecedents, structures, and processes. Although outreach clinics made treatment accessible to vulnerable populations, the protocol, which used medications with previously demonstrated efficacy, had little impact on reducing blood pressure in patients with severe hypertension.
摘要：
海地≥40岁成年人的高血压患病率几乎是美洲国家的两倍。海地健康倡议（HHI）制定了高血压管理协议，用于蒂莫的外展诊所，海地的一个农村山区社区。本研究旨在评估高血压方案治疗40岁以上成人和重度高血压孕妇的有效性。
■这项回顾性纵向研究包括了209名患者，共1148次门诊就诊/就诊。对2014年4月至2019年4月期间11个半年期外展诊所的去识别医疗记录进行了审查以进行分析。描述性统计，配对t检验，并进行了多层次模型。主要结果是每次临床就诊时的收缩压和舒张压测量。
■在研究中（n=1148次访问），高血压和重度高血压患病率分别为79·8%和38·4%。多水平模型显示每次就诊收缩压降低0·29mmHg（p=0·37），舒张压降低0·66mmHg（p<0·001）。个体因素和方案依从性不能预测血压的降低。
■有效管理难以接触到的人群中的高血压和其他慢性疾病需要全面的宣传工作，以解决护理前因，结构,和过程。尽管外展诊所使弱势群体可以获得治疗，协议,使用先前证明有效的药物，对重度高血压患者的血压降低影响不大。
■这项回顾性纵向研究包括了209名患者，共1148次门诊就诊/就诊。对2014年4月至2019年4月期间11个半年期外展诊所的去识别医疗记录进行了审查以进行分析。描述性统计，配对t检验，并进行了多层次模型。主要结果是每次临床就诊时的收缩压和舒张压测量。
■在研究中（n=1148次访问），高血压和重度高血压患病率分别为79·8%和38·4%。多水平模型显示每次就诊收缩压降低0·29mmHg（p=0·37），舒张压降低0·66mmHg（p<0·001）。个体因素和方案依从性不能预测血压的降低。
■有效管理难以接触到的人群中的高血压和其他慢性疾病需要全面的宣传工作，以解决护理前因，结构,和过程。尽管外展诊所使弱势群体可以获得治疗，协议,使用先前证明有效的药物，对重度高血压患者的血压降低影响不大。
