EFFECTIVENESS OF A MEDICAL EDUCATION INTERVENTION TO TREAT HYPERTENSION IN PRIMARY CARE
Author(s)
Martinez Valverde S1, Reyes Morales H2, Castro Rios A3, Perez Cuevas R3, Klunder Klunder M1, Salinas Escudero G41Hospital Infantil de México Federico Gómez, Mexico City, D.F., Mexico, 2Instituto Nacional de Salud Pública, Morelos, Mexico, 3Mexican Institu
OBJECTIVES: To report the effectiveness of a CME intervention to improve appropriate care for hypertension, which in turn has a positive effect on blood pressure control of hypertensive patients in primary care clinics. METHODS: A secondary data analysis was carried out using data of hypertensive patients treated by family doctors who participated in the CME intervention. The evaluation was designed as a pre-/post-intervention study with control group in six primary care clinics. The effect of the CME intervention was analysed using multiple logistic regression modelling in which the dependent variable was uncontrolled blood pressure in the postintervention patient measurement. The model was adjusted by considering the family doctors as a cluster unit. This allowed correcting the effect of including several patients who received treatment by the same doctor. Selection of regression variables was carried out by comparing χ2 values of the log likelihood in the models; this was carried out by using the backward stepwise procedure. Goodnessof-fit of the model was evaluated using the Hosmer–Lemeshow test. RESULTS: After the CME intervention, the net reduction of uncontrolled blood pressure between stages in the intervention group was 10.3%. The model results were that being treated by a family doctor who participated in the CME intervention reduced by 53% the probability of lack of control of blood pressure; receiving dietary recommendations reduced 57% the probability of uncontrolled blood pressure. Having uncontrolled blood pressure at the baseline stage increased the probability of lack of control in 166%, and per each unit of increase in body mass index the lack of control increased 7%. CONCLUSIONS: CME intervention improved the medical decision-making process to manage hypertension, thus increasing the probability of hypertensive patients to have blood pressure under control.
Conference/Value in Health Info
2011-05, ISPOR 2011, Baltimore, MD, USA
Value in Health, Vol. 14, No. 3 (May 2011)
Code
PCV84
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Treatment Patterns and Guidelines
Disease
Cardiovascular Disorders