Why the study?
Does coordinated, in-home care improve blood pressure control in medically fragile, low-income older or disabled adults?
Does coordinated, in-home care improve blood pressure control in medically fragile, low-income older or disabled adults?
A coordinated, in-home care model significantly improved blood pressure control in a population of low-income, frail older adults.
Supports evaluation of in-home care for hypertension in frail older adults; leaves open confirmation via randomized trials.
We evaluated hypertension management among enrollees in Just for Us (JFU)—an approach to providing coordinated, in-home care to medically fragile, low-income older or disabled adults living independently. The sample was 264 JFU patients who enrolled between January 1, 2002 and December 31, 2004, lived in a JFU building, and had blood pressure (BP) recorded 1 year from baseline. BP change was analyzed with paired t tests, and control status change with McNemar’s. Characteristics associated with change were explored with ordinary least squares (OLS) regression. For the 225 individuals with hypertension at baseline, average systolic pressure dropped 7.73 mmHg ( p < .001) and diastolic 4.41 mmHg ( p < .001). In the same group, 57.4% of those not in control at baseline were in control 1 year later; 19.7% of those in control at baseline moved out of control ( p < .001). BP declined across subgroups and was greater for African Americans, the predominant racial group. Additional evaluation of such models is warranted.
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Silberberg et al. (2010) studied this question.
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