Loading…
Home blood pressure monitoring, secure electronic messaging and medication intensification for improving hypertension control: a mediation analysis
We evaluated the role of home monitoring, communication with pharmacists, medication intensification, medication adherence and lifestyle factors in contributing to the effectiveness of an intervention to improve blood pressure control in patients with uncontrolled essential hypertension. We performe...
Saved in:
| Published in: | Applied clinical informatics 2014, Vol.5 (1), p.232-248 |
|---|---|
| Main Authors: | , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | |
|---|---|
| cites | cdi_FETCH-LOGICAL-c225t-d118d0891ec0d912ff778e1ef2392032a3dea8355b2d9e07bdcd984509388a073 |
| container_end_page | 248 |
| container_issue | 1 |
| container_start_page | 232 |
| container_title | Applied clinical informatics |
| container_volume | 5 |
| creator | Ralston, J D Cook, A J Anderson, M L Catz, S L Fishman, P A Carlson, J Johnson, R Green, B B |
| description | We evaluated the role of home monitoring, communication with pharmacists, medication intensification, medication adherence and lifestyle factors in contributing to the effectiveness of an intervention to improve blood pressure control in patients with uncontrolled essential hypertension.
We performed a mediation analysis of a published randomized trial based on the Chronic Care Model delivered over a secure patient website from June 2005 to December 2007. Study arms analyzed included usual care with a home blood pressure monitor and usual care with home blood pressure monitor and web-based pharmacist care. Mediator measures included secure messaging and telephone encounters; home blood pressure monitoring; medications intensification and adherence and lifestyle factors. Overall fidelity to the Chronic Care Model was assessed with the Patient Assessment of Chronic Care (PACIC) instrument. The primary outcome was percent of participants with blood pressure (BP) |
| doi_str_mv | 10.4338/ACI-2013-10-RA-0079 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3974258</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1516724852</sourcerecordid><originalsourceid>FETCH-LOGICAL-c225t-d118d0891ec0d912ff778e1ef2392032a3dea8355b2d9e07bdcd984509388a073</originalsourceid><addsrcrecordid>eNpVUdtqGzEUFKEhMam_IFD02IduqsuuJfWhYExuECiE5FnI0llbZVfaSuuAv6M_XG0ch1Qv0jkzZ86IQeiSkquac_l9ubqvGKG8oqR6XFaECHWCZlQuVEU4E58-vM_RPOffpJxmQaUUZ-ic1YLXlC9m6O9d7AGvuxgdHhLkvEuA-xj8GJMPm284g51a0IEdU-lb3BeW2RQQm-BK5bw1o48B-zBCyL491m1M2PdDii8TebsfIL0SCmRjKGrdD2xeBQ58E0y3zz5_Rqet6TLM3-4L9Hxz_bS6qx5-3d6vlg-VZawZK0epdEQqCpY4RVnbCiGBQsu4YuXjhjswkjfNmjkFRKyddUrWDVFcSkMEv0A_D7rDbl1cWCieTKeH5HuT9joar_9Hgt_qTXzRXImaNbIIfH0TSPHPDvKoe58tdJ0JEHdZ04YuBKtlwwqVH6g2xZwTtO9rKNFTorokqqdEp8bjUk-JlqkvHx2-zxzz4_8AvaWh3A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1516724852</pqid></control><display><type>article</type><title>Home blood pressure monitoring, secure electronic messaging and medication intensification for improving hypertension control: a mediation analysis</title><source>PubMed Central(OpenAccess)</source><creator>Ralston, J D ; Cook, A J ; Anderson, M L ; Catz, S L ; Fishman, P A ; Carlson, J ; Johnson, R ; Green, B B</creator><creatorcontrib>Ralston, J D ; Cook, A J ; Anderson, M L ; Catz, S L ; Fishman, P A ; Carlson, J ; Johnson, R ; Green, B B</creatorcontrib><description>We evaluated the role of home monitoring, communication with pharmacists, medication intensification, medication adherence and lifestyle factors in contributing to the effectiveness of an intervention to improve blood pressure control in patients with uncontrolled essential hypertension.
We performed a mediation analysis of a published randomized trial based on the Chronic Care Model delivered over a secure patient website from June 2005 to December 2007. Study arms analyzed included usual care with a home blood pressure monitor and usual care with home blood pressure monitor and web-based pharmacist care. Mediator measures included secure messaging and telephone encounters; home blood pressure monitoring; medications intensification and adherence and lifestyle factors. Overall fidelity to the Chronic Care Model was assessed with the Patient Assessment of Chronic Care (PACIC) instrument. The primary outcome was percent of participants with blood pressure (BP) <140/90 mm Hg.
At 12 months follow-up, patients in the web-based pharmacist care group were more likely to have BP <140/90 mm Hg (55%) compared to patients in the group with home blood pressure monitors only (37%) (p = 0.001). Home blood pressure monitoring accounted for 30.3% of the intervention effect, secure electronic messaging accounted for 96%, and medication intensification for 29.3%. Medication adherence and self-report of fruit and vegetable intake and weight change were not different between the two study groups. The PACIC score accounted for 22.0 % of the main intervention effect.
The effect of web-based pharmacist care on improved blood pressure control was explained in part through a combination of home blood pressure monitoring, secure messaging, and antihypertensive medication intensification.</description><identifier>ISSN: 1869-0327</identifier><identifier>EISSN: 1869-0327</identifier><identifier>DOI: 10.4338/ACI-2013-10-RA-0079</identifier><identifier>PMID: 24734136</identifier><language>eng</language><publisher>Germany: Schattauer</publisher><subject>Antihypertensive Agents - therapeutic use ; Blood Pressure Monitoring, Ambulatory ; Female ; Follow-Up Studies ; Humans ; Hypertension - drug therapy ; Male ; Middle Aged ; Negotiating ; Randomized Controlled Trials as Topic ; Telemedicine - methods</subject><ispartof>Applied clinical informatics, 2014, Vol.5 (1), p.232-248</ispartof><rights>Copyright Schattauer 2014 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c225t-d118d0891ec0d912ff778e1ef2392032a3dea8355b2d9e07bdcd984509388a073</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974258/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974258/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,27923,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24734136$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ralston, J D</creatorcontrib><creatorcontrib>Cook, A J</creatorcontrib><creatorcontrib>Anderson, M L</creatorcontrib><creatorcontrib>Catz, S L</creatorcontrib><creatorcontrib>Fishman, P A</creatorcontrib><creatorcontrib>Carlson, J</creatorcontrib><creatorcontrib>Johnson, R</creatorcontrib><creatorcontrib>Green, B B</creatorcontrib><title>Home blood pressure monitoring, secure electronic messaging and medication intensification for improving hypertension control: a mediation analysis</title><title>Applied clinical informatics</title><addtitle>Appl Clin Inform</addtitle><description>We evaluated the role of home monitoring, communication with pharmacists, medication intensification, medication adherence and lifestyle factors in contributing to the effectiveness of an intervention to improve blood pressure control in patients with uncontrolled essential hypertension.
We performed a mediation analysis of a published randomized trial based on the Chronic Care Model delivered over a secure patient website from June 2005 to December 2007. Study arms analyzed included usual care with a home blood pressure monitor and usual care with home blood pressure monitor and web-based pharmacist care. Mediator measures included secure messaging and telephone encounters; home blood pressure monitoring; medications intensification and adherence and lifestyle factors. Overall fidelity to the Chronic Care Model was assessed with the Patient Assessment of Chronic Care (PACIC) instrument. The primary outcome was percent of participants with blood pressure (BP) <140/90 mm Hg.
At 12 months follow-up, patients in the web-based pharmacist care group were more likely to have BP <140/90 mm Hg (55%) compared to patients in the group with home blood pressure monitors only (37%) (p = 0.001). Home blood pressure monitoring accounted for 30.3% of the intervention effect, secure electronic messaging accounted for 96%, and medication intensification for 29.3%. Medication adherence and self-report of fruit and vegetable intake and weight change were not different between the two study groups. The PACIC score accounted for 22.0 % of the main intervention effect.
The effect of web-based pharmacist care on improved blood pressure control was explained in part through a combination of home blood pressure monitoring, secure messaging, and antihypertensive medication intensification.</description><subject>Antihypertensive Agents - therapeutic use</subject><subject>Blood Pressure Monitoring, Ambulatory</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hypertension - drug therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Negotiating</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Telemedicine - methods</subject><issn>1869-0327</issn><issn>1869-0327</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNpVUdtqGzEUFKEhMam_IFD02IduqsuuJfWhYExuECiE5FnI0llbZVfaSuuAv6M_XG0ch1Qv0jkzZ86IQeiSkquac_l9ubqvGKG8oqR6XFaECHWCZlQuVEU4E58-vM_RPOffpJxmQaUUZ-ic1YLXlC9m6O9d7AGvuxgdHhLkvEuA-xj8GJMPm284g51a0IEdU-lb3BeW2RQQm-BK5bw1o48B-zBCyL491m1M2PdDii8TebsfIL0SCmRjKGrdD2xeBQ58E0y3zz5_Rqet6TLM3-4L9Hxz_bS6qx5-3d6vlg-VZawZK0epdEQqCpY4RVnbCiGBQsu4YuXjhjswkjfNmjkFRKyddUrWDVFcSkMEv0A_D7rDbl1cWCieTKeH5HuT9joar_9Hgt_qTXzRXImaNbIIfH0TSPHPDvKoe58tdJ0JEHdZ04YuBKtlwwqVH6g2xZwTtO9rKNFTorokqqdEp8bjUk-JlqkvHx2-zxzz4_8AvaWh3A</recordid><startdate>2014</startdate><enddate>2014</enddate><creator>Ralston, J D</creator><creator>Cook, A J</creator><creator>Anderson, M L</creator><creator>Catz, S L</creator><creator>Fishman, P A</creator><creator>Carlson, J</creator><creator>Johnson, R</creator><creator>Green, B B</creator><general>Schattauer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>2014</creationdate><title>Home blood pressure monitoring, secure electronic messaging and medication intensification for improving hypertension control: a mediation analysis</title><author>Ralston, J D ; Cook, A J ; Anderson, M L ; Catz, S L ; Fishman, P A ; Carlson, J ; Johnson, R ; Green, B B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c225t-d118d0891ec0d912ff778e1ef2392032a3dea8355b2d9e07bdcd984509388a073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Antihypertensive Agents - therapeutic use</topic><topic>Blood Pressure Monitoring, Ambulatory</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hypertension - drug therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Negotiating</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Telemedicine - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ralston, J D</creatorcontrib><creatorcontrib>Cook, A J</creatorcontrib><creatorcontrib>Anderson, M L</creatorcontrib><creatorcontrib>Catz, S L</creatorcontrib><creatorcontrib>Fishman, P A</creatorcontrib><creatorcontrib>Carlson, J</creatorcontrib><creatorcontrib>Johnson, R</creatorcontrib><creatorcontrib>Green, B B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Applied clinical informatics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ralston, J D</au><au>Cook, A J</au><au>Anderson, M L</au><au>Catz, S L</au><au>Fishman, P A</au><au>Carlson, J</au><au>Johnson, R</au><au>Green, B B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Home blood pressure monitoring, secure electronic messaging and medication intensification for improving hypertension control: a mediation analysis</atitle><jtitle>Applied clinical informatics</jtitle><addtitle>Appl Clin Inform</addtitle><date>2014</date><risdate>2014</risdate><volume>5</volume><issue>1</issue><spage>232</spage><epage>248</epage><pages>232-248</pages><issn>1869-0327</issn><eissn>1869-0327</eissn><abstract>We evaluated the role of home monitoring, communication with pharmacists, medication intensification, medication adherence and lifestyle factors in contributing to the effectiveness of an intervention to improve blood pressure control in patients with uncontrolled essential hypertension.
We performed a mediation analysis of a published randomized trial based on the Chronic Care Model delivered over a secure patient website from June 2005 to December 2007. Study arms analyzed included usual care with a home blood pressure monitor and usual care with home blood pressure monitor and web-based pharmacist care. Mediator measures included secure messaging and telephone encounters; home blood pressure monitoring; medications intensification and adherence and lifestyle factors. Overall fidelity to the Chronic Care Model was assessed with the Patient Assessment of Chronic Care (PACIC) instrument. The primary outcome was percent of participants with blood pressure (BP) <140/90 mm Hg.
At 12 months follow-up, patients in the web-based pharmacist care group were more likely to have BP <140/90 mm Hg (55%) compared to patients in the group with home blood pressure monitors only (37%) (p = 0.001). Home blood pressure monitoring accounted for 30.3% of the intervention effect, secure electronic messaging accounted for 96%, and medication intensification for 29.3%. Medication adherence and self-report of fruit and vegetable intake and weight change were not different between the two study groups. The PACIC score accounted for 22.0 % of the main intervention effect.
The effect of web-based pharmacist care on improved blood pressure control was explained in part through a combination of home blood pressure monitoring, secure messaging, and antihypertensive medication intensification.</abstract><cop>Germany</cop><pub>Schattauer</pub><pmid>24734136</pmid><doi>10.4338/ACI-2013-10-RA-0079</doi><tpages>17</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1869-0327 |
| ispartof | Applied clinical informatics, 2014, Vol.5 (1), p.232-248 |
| issn | 1869-0327 1869-0327 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3974258 |
| source | PubMed Central(OpenAccess) |
| subjects | Antihypertensive Agents - therapeutic use Blood Pressure Monitoring, Ambulatory Female Follow-Up Studies Humans Hypertension - drug therapy Male Middle Aged Negotiating Randomized Controlled Trials as Topic Telemedicine - methods |
| title | Home blood pressure monitoring, secure electronic messaging and medication intensification for improving hypertension control: a mediation analysis |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-29T05%3A33%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Home%20blood%20pressure%20monitoring,%20secure%20electronic%20messaging%20and%20medication%20intensification%20for%20improving%20hypertension%20control:%20a%20mediation%20analysis&rft.jtitle=Applied%20clinical%20informatics&rft.au=Ralston,%20J%20D&rft.date=2014&rft.volume=5&rft.issue=1&rft.spage=232&rft.epage=248&rft.pages=232-248&rft.issn=1869-0327&rft.eissn=1869-0327&rft_id=info:doi/10.4338/ACI-2013-10-RA-0079&rft_dat=%3Cproquest_pubme%3E1516724852%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c225t-d118d0891ec0d912ff778e1ef2392032a3dea8355b2d9e07bdcd984509388a073%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1516724852&rft_id=info:pmid/24734136&rfr_iscdi=true |