Hypertension management for community dwelling older people with diabetes in Nanchang, China: a cluster randomised controlled trial
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Copyright © 2018 the author. All rights reserved.
Background Although China has a large number of older people living with diabetes and hypertension, the primary care system is underdeveloped and so management of these conditions in community care settings is suboptimal. Methods A cluster randomized controlled trial was conducted to randomly allocate 10 wards from four hospitals in Nanchang to either an intervention group (N=5) or a usual care group (N=5). In total, 270 patients were recruited in the study. The intervention included individualized self-care education and medication management prior to discharge and in the 6-month follow-up in community health service centres. A multilevel mixed-effect linear regression model was applied to compare the changes in health outcomes between the intervention and usual care groups. Results The intervention group demonstrated a statistically significant decrease of a mean systolic blood pressure of 10.7 mm Hg (95%CI: -14.2 to -7.1, P<0.001) and a mean diastolic blood pressure of 4.1 mm Hg (95% CI: -6.2 to -2.0, P<0.001) over 6 months as compared to the usual care group. Findings also demonstrated significant improvements of HbA1c, hypertension knowledge, diabetes knowledge, treatment adherence, quality of life, the prevention of adverse events and hospital readmission at 6 months in the intervention group compared to the usual care group. Conclusion A hypertension management program that targeted individualized self-care and medication management improved hypertension control for older people with diabetes in the community care setting.
This abstract was prepared for the inaugural 'HDR Student Conference', Flinders University, November 2018. Copyright © the author
Hypertension, Diabetes, Collaborative Care, Primary health system, China
Tu, Qiang (2018, November) Hypertension management for community dwelling older people with diabetes in Nanchang, China: a cluster randomised controlled trial Paper presented at 'HDR Student conference', Flinders University, Bedford Park.