What question did this study set out to answer?

To investigate the effect of an access-enhanced intervention on hypertension management and health behaviors in a low SES community.

September 15, 2013Annals of the Academy of Medicine SingaporeOpen Access

Hypertension Management and Lifestyle Changes Following Screening for Hypertension in an Asian Low Socioeconomic Status Community: A Prospective Study

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Hypertension (n=577). Intervention: Access-enhanced community-based screening and education intervention vs. Baseline (pre-intervention). Primary outcome: Initiation of hypertension treatment among previously untreated hypertensives.

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Key result

A community-based access-enhanced intervention resulted in 51.6% of previously untreated hypertensives initiating treatment and 53.0% of uncontrolled hypertensives achieving blood pressure control after one year.

Why the study?

Does an access-enhanced community intervention improve hypertension screening, treatment, and control in a low socioeconomic status Asian community?

Population

577 residents aged ≥40 years living in 2 public rental housing precincts in Singapore. The 1-year follow-up…

Design

Cohort

Follow-up

1 year

Authors

LWLiang En WeeAgency for Science, Technology and Research JWJolene Si Min WongSingHealth Duke-NUS Academic Medical Centre RCRun Ting ChinNational University Hospital

Discussion

Member takes

Implication

May support community interventions for hypertension in low-SES Asian populations; leaves open need for RCTs to confirm efficacy.

Key Points

To investigate the effect of an access-enhanced intervention on hypertension management and health behaviors in a low SES community.
Involved residents aged ≥40 in low SES housing from 2009 to 2011.
Followed up for 1 year after a 6-month community-based intervention including screening and outreach.
Utilized multivariate Cox regression to determine predictors of hypertension management.
80.9% follow-up rate with 467 participants.
Post-intervention, 53% of previously untreated hypertensives achieved control; 51.6% of untreated hypertensives were treated.
Barriers to treatment included cost and misperceptions, with newly diagnosed hypertensives less likely to pursue additional cardiovascular screening.

Study Design

Type

Cohort (n=577)

Multicenter

Structured PICO

Does an access-enhanced community intervention improve hypertension screening, treatment, and control in a low socioeconomic status Asian community?

Population

577 residents aged 40 years and older living in low socioeconomic status public rental housing precincts in Singapore, followed prospectively for 1 year after a community-based hypertension screening and education intervention.

Intervention

A 6-month community-based access-enhanced intervention comprising a 3-month screening phase (door-to-door blood pressure measurement by trained student volunteers) and a 3-month follow-up phase (monthly home visits for chronic disease education, lifestyle advice, and screening encouragement).

Outcome

Hypertension management at 1-year follow-up, specifically the proportion of untreated hypertensives going on treatment, uncontrolled hypertensives achieving blood pressure control, and non-hypertensives going for regular screening.

A community-based, access-enhanced intervention in a low-income Asian population improved hypertension treatment and control rates but was less effective at encouraging lifestyle changes and additional cardiovascular screening.

Limitations

Potential selection bias due to loss-to-follow-up
Relatively short follow-up period of 1 year

Cite This Study

Wee et al. (2013) conducted a cohort in Hypertension (n=577). Access-enhanced community-based screening and education intervention vs. Baseline (pre-intervention) was evaluated on Initiation of hypertension treatment among previously untreated hypertensives. A community-based access-enhanced intervention resulted in 51.6% of previously untreated hypertensives initiating treatment and 53.0% of uncontrolled hypertensives achieving blood pressure control after one year.

synapsesocial.com/papers/6a208bb3bb4ba07152cc4299 https://doi.org/10.47102/annals-acadmedsg.v42n9p451

Topics

Hypertension management

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Hypertension Management and Lifestyle Changes Following Screening for Hypertension in an Asian Low Socioeconomic Status Community: A Prospective Study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Topics

Hypertension Management and Lifestyle Changes Following Screening for Hypertension in an Asian Low Socioeconomic Status Community: A Prospective Study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider