Six monthly follow-up is as effective as 3 monthly follow-up for people with hypertension

Mark R Nelson MBBS(Hons), MFM, FRACGP, PhD, FAFPHM (Commentary Author)
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Abstract

Question

In people with treated hypertension, how effective is 3 month follow-up by a family physician compared with 6 month follow-up, in terms of blood pressure control, patient satisfaction and adherence to drug treatment over 3 years?

Study design

Randomised controlled trial.

Main results

At 36 months, mean blood pressure, patient satisfaction and adherence to treatment was equivalent between treatment groups (see Table 1).

Table 1 Outcome measures at 36 months for people receiving 3 or 6 month follow-up by a family practitioner.
3 months (N=302)6 months (N=307)Difference (SE)Equivalence 90% CI
% Participants with out of control blood pressure*18%16%Not stated
Mean systolic blood pressure133.50135.84−2.35 (1.52)−4.84 to 0.15
Mean diastolic blood pressure81.7081.450.25 (1.12)−1.61 to 2.11
General satisfaction with clinical care73%75%−2.69−5.76 to 0.38
% of participants answering ‘yes’ to the question: ‘Did I ever forget to take my pills?’78/263 (30%)71/263 (27%)2.96 (3.92)−3.48 to 9.41
*As assessed by doctor; authors state no significant difference between groups, but statistics not presented.
If the 90% CI falls entirely within the predefined equivalence range (±5 mmHg for both systolic and diastolic blood pressure and ±10% for patient satisfaction and adherence), the groups are considered equivalent.

Authors’ conclusions

In people with controlled hypertension, 6 monthly follow-up is as effective as 3 monthly follow-up over 3 years for control of blood pressure, patient satisfaction and adherence to treatment, and has no effect on the proportion of participants with out of control blood pressure.

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对于高血压患者,6个月随访和3个月随访同样有效
问题在高血压患者中,在血压控制、患者满意度和3年以上药物治疗依从性方面,由家庭医生进行的3个月随访与6个月随访相比,效果如何?研究设计随机对照试验。主要结果36个月后,各治疗组的平均血压、患者满意度和治疗依从性相当(见表1)。表1接受家庭医生3个月或6个月随访的患者在36个月时的结果测量。3个月(N=302)6个月(N=307)差异(SE)等效90%CI†%血压失控的参与者*18%16%未说明平均收缩压133.50135.84−2.35(1.52)−4.84至0.15平均舒张压81.7081.450.25(1.12)−1.61至2.11总体满意度临床护理73%的参与者回答“是”:“我忘了吃药吗?”78/263(30%)71/263(27%)2.96(3.92)−3.48至9.41*经医生评估;作者表示,各组之间没有显著差异,但没有提供统计数据。†如果90%CI完全落在预定义的等效范围内(收缩压和舒张压均为±5 mmHg,患者满意度和依从性为±10%),则两组被视为等效。作者的结论:在控制性高血压患者中,在血压控制、患者满意度和坚持治疗方面,6个月的随访与3年的3个月随访一样有效,并且对血压失控的参与者比例没有影响。
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