Comparative Effectiveness of a Practice-Based Comprehensive Lifestyle Intervention vs. Single Session Counseling in Hypertensive Blacks
Autor: | Taiye Odedosu, Antoinette Schoenthaler, Jeanne A. Teresi, Leanne Luerassi, Gbenga Ogedegbe, Stephanie Silver, Joseph Ravenell, Jian Kong |
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Jazyk: | angličtina |
Rok vydání: | 2015 |
Předmět: |
Male
medicine.medical_specialty Comparative effectiveness research Diastole Psychological intervention Motivational interviewing Directive Counseling Motivational Interviewing 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Lifestyle intervention Internal Medicine medicine Humans 030212 general & internal medicine Life Style Aged business.industry Middle Aged Clinical trial Black or African American Blood pressure Hypertension Physical therapy Original Article Female business Single session |
Popis: | BACKGROUND Although the efficacy of therapeutic lifestyle change (TLC) interventions are well proven, their relative effectiveness vs. single-session lifestyle counseling (SSC) on blood pressure (BP) reduction in primary care practices remains largely untested in hypertensive Blacks. The aim of this trial was to evaluate the comparative effectiveness of a comprehensive practice-based TLC intervention (motivational interviewing (MINT)-TLC) vs. SSC on BP reduction among 194 Blacks with uncontrolled hypertension. METHODS The MINT-TLC arm included 10 weekly group classes on TLC, followed by 3 individual MINT sessions. The SSC group received 1 individual counseling session on lifestyle modification plus print versions of the intervention material. The primary outcome was within-patient change in systolic BP (SBP) and diastolic BP (DBP) from baseline to 6 months. The secondary outcome was BP control at 6 months. RESULTS Mean age of the total sample was 57 (10.2) years; 50% were women, and the mean baseline BP was 147.4/89.3mm Hg. Eighty-four percent of SSC and 77% of MINT-TLC patients completed the final 6-month assessments. BP declined significantly (P < 0.001) in both groups at 6 months with a net-adjusted systolic BP reduction of 12.9 mm Hg for the SSC group vs. 9.5mm Hg for the MINT-TLC group (P = 0.18); and diastolic BP reduction of 7.6 and 7.2mm Hg for the SSC and MINT-TLC group, respectively (P = 0.79). The between-group difference in proportion of patients with adequate BP control at 6 months was nonsignificant (P = 0.82). CONCLUSION A significant group difference in BP between the intervention groups was not observed among a sample of hypertensive Blacks. Implementation of the pragmatic single-session intervention and its effects on utilization of healthcare services should be further evaluated. CLINICAL TRIAL REGISTRATION Trial Number NCT01070056 at http://clinicaltrials.gov/ct2/show/NCT01070056?term=TLC+clinic&rank=1. |
Databáze: | OpenAIRE |
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