患者护理团队对高血压患者血压控制的影响:系统回顾和荟萃分析。

IF 4.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE
Yuichi Akasaki, Yasunori Suematsu, Kengo Azushima, Yuhei Shiga, Atsushi Sakima, Michihiro Satoh, Hisatomi Arima, Nobuhito Hirawa
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引用次数: 0

摘要

高血压是心血管疾病的一个重要危险因素,其全球患病率在过去三十年中翻了一番。尽管降压治疗取得了进展,但仍有大约50%的高血压患者未能达到目标血压(BP)水平,这凸显了创新护理策略的必要性。由多学科医疗保健提供者组成的患者护理团队在改善BP管理方面表现出了希望。本系统综述和荟萃分析旨在评估包括医生在内的患者护理团队在高血压管理中的有效性。为此,我们综合检索PubMed、Cochrane CENTRAL和IchuShi-Web,共纳入61项随机对照试验,包括64,857名受试者。与常规护理相比,患者护理团队的干预显著降低了办公室收缩压(平均差异:-6.31 mmHg;95%可信区间:-7.71 ~ -4.90),血压失控风险降低27%(风险比:0.73;95%置信区间:0.68-0.79)。亚组分析表明,在不同的团队领导角色中,如医生、护士和药剂师,以及不同的干预持续时间,血压都有一致的降低。这些发现强调了以团队为基础的血压管理在改善血压控制方面的有效性,无论团队组成或随访时间如何。多学科护理为解决高血压患者未满足的需求提供了一种可行的方法,可能改善心血管预后。这一证据支持将患者护理团队纳入高血压管理,特别是在需要医生监督的情况下。未来的研究应侧重于改进团队结构和定制干预措施,以适应不同的医疗环境,以增强其影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of patient care teams on blood pressure control in patients with hypertension: a systematic review and meta-analysis.

Hypertension is a significant risk factor for cardiovascular diseases, with its global prevalence doubling over the past three decades. Despite advancements in antihypertensive therapies, approximately 50% of patients with hypertension fail to achieve their target blood pressure (BP) levels, underscoring the need for innovative care strategies. Patient care teams comprising multidisciplinary healthcare providers have shown promise in improving BP management. This systematic review and meta-analysis were aimed at evaluating the effectiveness of patient care teams involving physicians in hypertension management. To this end, PubMed, Cochrane CENTRAL, and IchuShi-Web were comprehensively searched and 61 randomized controlled trials including 64,857 participants were identified. Compared with usual care, interventions by patient care teams significantly reduced office systolic BP (mean difference: -6.31 mmHg; 95% confidence interval: -7.71 to -4.90) and decreased the risk of uncontrolled BP by 27% (risk ratio: 0.73; 95% confidence interval: 0.68-0.79). Subgroup analyses demonstrated consistent BP reductions across various team leadership roles, such as physicians, nurses, and pharmacists, and across different intervention durations. These findings highlight the effectiveness of team-based BP management in achieving improved BP control, regardless of team composition or the follow-up period. Multidisciplinary care offers a viable approach to addressing the unmet needs of patients with hypertension, potentially improving cardiovascular outcomes. This evidence supports integrating patient care teams into hypertension management, particularly in settings requiring physician oversight. Future research should focus on refining team structures and tailoring interventions to diverse healthcare environments to enhance their impact.

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来源期刊
Hypertension Research
Hypertension Research 医学-外周血管病
CiteScore
7.40
自引率
16.70%
发文量
249
审稿时长
3-8 weeks
期刊介绍: Hypertension Research is the official publication of the Japanese Society of Hypertension. The journal publishes papers reporting original clinical and experimental research that contribute to the advancement of knowledge in the field of hypertension and related cardiovascular diseases. The journal publishes Review Articles, Articles, Correspondence and Comments.
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