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Management of hypertension and multiple risk factors to enhance cardiovascular health - a feasibility study in Singapore polyclinics

Overview of attention for article published in BMC Health Services Research, July 2016
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Title
Management of hypertension and multiple risk factors to enhance cardiovascular health - a feasibility study in Singapore polyclinics
Published in
BMC Health Services Research, July 2016
DOI 10.1186/s12913-016-1491-6
Pubmed ID
Authors

Tazeen H. Jafar, Ngiap C. Tan, John C. Allen, Shreyasee S. Pradhan, Paul Goh, Saeideh Tavajoh, Fong M. Keng, Jason Chan

Abstract

High blood pressure (BP) is a leading contributor to cardiovascular mortality globally. There is scarcity of information on effective health systems interventions to lower BP and reduce cardiovascular risk in Southeast Asian countries. We conducted a pilot exploratory trial on 100 adults aged 40 years or older with uncontrolled hypertension to optimize the design for a structured multi-component intervention in primary care clinics for management of hypertension. Two clinics were involved, each enrolling 50 participants, with one as the intervention clinic and the other as the control (usual care). The intervention comprised the following four components: 1) an algorithm-driven intervention using a fixed-dose combination (FDC) antihypertensive treatment and lipid lowering medication for high risk individuals, 2) subsidized FDC antihypertensive medication; 3) motivational conversation (MC) for high risk individuals; and 4) telephone follow-ups of all individuals. The process outcomes were intervention fidelity measures. The outcomes of change in parameters of interest were healthy lifestyle index (composite score of body mass index, physical activity, dietary habit, dietary quality and smoking), adherence to antihypertensive medications, and systolic and diastolic BP from baseline to follow-up at 3 months. Greater than 90 % fidelity was achieved for 3 of the 4 intervention components. Although not designed for conclusive results, the healthy lifestyle score increased by 0.16 (±0.68) with the intervention and decreased by 0.18 (±0.75) with usual care (p = 0.02). Adherence to anti-hypertensive medications at follow-up was 95.3 % in the intervention group compared to 83.8 % for usual care (p = 0.01). Systolic and diastolic BP decreased in both intervention and control groups, although statistical significance between groups was not achieved. Hypertensive individuals rated all intervention components 'highly favorable' on a Likert scale. Our findings indicate that the proposed, structured multi-component approach for management of hypertension is feasible for implementation in primary care clinics in Singapore, with some changes to the protocol. The observed improvement in the healthy lifestyle index and adherence to anti-hypertensive medications is promising. A large scale, adequately powered trial would be informative to assess intervention effectiveness on BP and cardiovascular risk reduction. This trial has been registered at ClinicalTrials.gov. ClinicalTrials.gov number NCT02330224 . Registered on 28 December 2014.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 56 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Netherlands 1 2%
Unknown 55 98%

Demographic breakdown

Readers by professional status Count As %
Unspecified 13 23%
Student > Master 11 20%
Researcher 8 14%
Student > Ph. D. Student 6 11%
Student > Postgraduate 4 7%
Other 14 25%
Readers by discipline Count As %
Medicine and Dentistry 19 34%
Unspecified 18 32%
Nursing and Health Professions 8 14%
Pharmacology, Toxicology and Pharmaceutical Science 3 5%
Mathematics 2 4%
Other 6 11%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 July 2016.
All research outputs
#4,232,038
of 8,029,393 outputs
Outputs from BMC Health Services Research
#2,067
of 3,013 outputs
Outputs of similar age
#141,235
of 259,565 outputs
Outputs of similar age from BMC Health Services Research
#112
of 155 outputs
Altmetric has tracked 8,029,393 research outputs across all sources so far. This one is in the 27th percentile – i.e., 27% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,013 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.3. This one is in the 20th percentile – i.e., 20% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 259,565 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 35th percentile – i.e., 35% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 155 others from the same source and published within six weeks on either side of this one. This one is in the 16th percentile – i.e., 16% of its contemporaries scored the same or lower than it.