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Abstract：
BACKGROUND: Hypertension is one of the most common chronic diseases with a low control rate globally. The effect of communication skills training contributing to hypertension control remains uncertain. The aim of the present study was to assess the effectiveness of an educational intervention based on the Calgary-Cambridge guide in improving hypertensive management.
METHODS: A cluster randomized controlled trial enrolled 27 general practitioners (GPs) and 540 uncontrolled hypertensive patients attending 6 community health centers in Chengdu, China. GPs allocated to the intervention group were trained by an online communication course and two face-to-face workshops based on Calgary-Cambridge guides. The primary outcome was blood pressure (BP) control rates and reductions in systolic and diastolic BP from baseline to 3 months. The secondary outcome was changes in GPs\' communication skills after one month, patients\' knowledge and satisfaction after 3 months. Bivariate analysis and the regression model assessed whether the health provider training improved outcomes.
RESULTS: After the communication training, the BP control rate was significantly higher (57.2% vs. 37.4%, p < 0.001) in the intervention groups. Compared to the control group, there was a significant improvement in GP\'s communication skills (13.0 vs 17.5, p < 0.001), hypertensive patients\' knowledge (18.0 vs 20.0, p < 0.001), and systolic blood pressure (139.1 vs 134.7, p < 0.001) after 3 months of follow-up. Random effects least squares regression models showed significant interactions between the intervention group and time period in the change of GP\'s communication skills (Parameter Estimated (PE): 0.612, CI:0.310,0.907, p = 0.006), hypertensive patient\'s knowledge (PE:0.233, CI: 0.098, 0.514, p < 0.001), satisfaction (PE:0.495, CI: 0.116, 0.706, p = 0.004), SBP (PE:-0.803, CI: -1.327, -0.389, p < 0.001) and DBP (PE:-0.918, CI: -1.694, -0.634, p < 0.001), from baseline to follow-up.
CONCLUSIONS: Communication training based on the Calgary-Cambridge guide for GPs has shown to be an efficient way in the short term to improve patient-provider communication skills and hypertension outcomes among patients with uncontrolled BPs.
BACKGROUND: The trial was registered on Chinese Clinical Trials Registry on 2019-04-03. (ChiCTR1900022278).
METHODS: A cluster randomized controlled trial enrolled 27 general practitioners (GPs) and 540 uncontrolled hypertensive patients attending 6 community health centers in Chengdu, China. GPs allocated to the intervention group were trained by an online communication course and two face-to-face workshops based on Calgary-Cambridge guides. The primary outcome was blood pressure (BP) control rates and reductions in systolic and diastolic BP from baseline to 3 months. The secondary outcome was changes in GPs\' communication skills after one month, patients\' knowledge and satisfaction after 3 months. Bivariate analysis and the regression model assessed whether the health provider training improved outcomes.
RESULTS: After the communication training, the BP control rate was significantly higher (57.2% vs. 37.4%, p < 0.001) in the intervention groups. Compared to the control group, there was a significant improvement in GP\'s communication skills (13.0 vs 17.5, p < 0.001), hypertensive patients\' knowledge (18.0 vs 20.0, p < 0.001), and systolic blood pressure (139.1 vs 134.7, p < 0.001) after 3 months of follow-up. Random effects least squares regression models showed significant interactions between the intervention group and time period in the change of GP\'s communication skills (Parameter Estimated (PE): 0.612, CI:0.310,0.907, p = 0.006), hypertensive patient\'s knowledge (PE:0.233, CI: 0.098, 0.514, p < 0.001), satisfaction (PE:0.495, CI: 0.116, 0.706, p = 0.004), SBP (PE:-0.803, CI: -1.327, -0.389, p < 0.001) and DBP (PE:-0.918, CI: -1.694, -0.634, p < 0.001), from baseline to follow-up.
CONCLUSIONS: Communication training based on the Calgary-Cambridge guide for GPs has shown to be an efficient way in the short term to improve patient-provider communication skills and hypertension outcomes among patients with uncontrolled BPs.
BACKGROUND: The trial was registered on Chinese Clinical Trials Registry on 2019-04-03. (ChiCTR1900022278).
摘要：
背景：高血压是全球最常见的慢性疾病之一，控制率低。沟通技巧训练对高血压控制的影响尚不确定。本研究的目的是评估基于卡尔加里-剑桥指南的教育干预措施在改善高血压管理方面的有效性。
方法：一项整群随机对照试验，纳入了在成都市6个社区卫生中心就诊的27名全科医生和540名未控制的高血压患者，中国。分配给干预组的全科医生通过在线交流课程和两次基于卡尔加里-剑桥指南的面对面研讨会进行了培训。主要结果是血压（BP）控制率以及从基线到3个月的收缩压和舒张压降低。次要结果是一个月后全科医生沟通技巧的变化，3个月后患者的知识和满意度。双变量分析和回归模型评估了健康提供者培训是否改善了结果。
结果：在沟通培训之后，血压控制率明显较高(57.2%vs.37.4%,干预组p<0.001)。与对照组相比,GP的沟通技巧有显著提高(13.0vs17.5，p<0.001)，高血压患者的知识（18.0vs20.0，p<0.001），随访3个月后收缩压（139.1vs134.7，p<0.001）。随机效应最小二乘回归模型显示，干预组和GP沟通技巧变化的时间段之间存在显著的交互作用(参数估计(PE):0.612,CI:0.310,0.907,p=0.006),高血压患者的知识（PE：0.233，CI：0.098，0.514，p<0.001），满意度（PE：0.495，CI：0.116，0.706，p=0.004），SBP（PE：-0.803，CI：-1.327，-0.389，p<0.001）和DBP（PE：-0.918，CI：-1.694，-0.634，p<0.001），从基线到随访。
结论：基于卡尔加里-剑桥全科医生指南的沟通培训已被证明是在短期内改善患者-提供者沟通技巧和高血压预后的有效方法。
背景：该试验于2019-04-03在中国临床试验注册中心注册。（ChiCTR1900022278）。
方法：一项整群随机对照试验，纳入了在成都市6个社区卫生中心就诊的27名全科医生和540名未控制的高血压患者，中国。分配给干预组的全科医生通过在线交流课程和两次基于卡尔加里-剑桥指南的面对面研讨会进行了培训。主要结果是血压（BP）控制率以及从基线到3个月的收缩压和舒张压降低。次要结果是一个月后全科医生沟通技巧的变化，3个月后患者的知识和满意度。双变量分析和回归模型评估了健康提供者培训是否改善了结果。
结果：在沟通培训之后，血压控制率明显较高(57.2%vs.37.4%,干预组p<0.001)。与对照组相比,GP的沟通技巧有显著提高(13.0vs17.5，p<0.001)，高血压患者的知识（18.0vs20.0，p<0.001），随访3个月后收缩压（139.1vs134.7，p<0.001）。随机效应最小二乘回归模型显示，干预组和GP沟通技巧变化的时间段之间存在显著的交互作用(参数估计(PE):0.612,CI:0.310,0.907,p=0.006),高血压患者的知识（PE：0.233，CI：0.098，0.514，p<0.001），满意度（PE：0.495，CI：0.116，0.706，p=0.004），SBP（PE：-0.803，CI：-1.327，-0.389，p<0.001）和DBP（PE：-0.918，CI：-1.694，-0.634，p<0.001），从基线到随访。
结论：基于卡尔加里-剑桥全科医生指南的沟通培训已被证明是在短期内改善患者-提供者沟通技巧和高血压预后的有效方法。
背景：该试验于2019-04-03在中国临床试验注册中心注册。（ChiCTR1900022278）。
