title: Effects of efforts to intensify management on blood pressure control among patients with type 2 diabetes mellitus and hypertension: a pilot study.
abstract: There continues to be a need for improved medical management of diabetes patients with hypertension in primary care. While several care models have shown effectiveness in achieving various outcomes among these patients, it remains unclear what care model is most effective in improving blood pressure control in primary care. In this prospective study, 54 patients with type 2 diabetes mellitus and blood pressure of >140/90 identified through the registry, were randomized into three groups. Group A attended a nurse educator-conducted class on diabetes and hypertension, group B attended the same class and was asked to monitor their home blood pressure using provided device, and group C served as control (usual care). Of the 24 subjects who completed the study, only 20% achieved the target blood pressure of <130/80 and there was no statistical difference in mean systolic and diastolic blood pressures among the three groups (p > 0.05). Efforts to intensify management of hypertension among type 2 diabetes patients did not result in better blood pressure control compared to usual care. Studies looking into factors which limit patients' participation in group classes and determining patients' preferences in disease management would be helpful in ensuring success of any chronic disease management program.
authors.affiliation: Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA. dejesus.ramona@mayo.edu
authors.forename: Ramona S
authors.initials: RS
authors.lastname: Dejesus
authors.forename: Rajeev
authors.initials: R
authors.lastname: Chaudhry
authors.forename: Dorinda J
authors.initials: DJ
authors.lastname: Leutink
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Hinton
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Cha
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stroebel
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy / Q000451:nursing / Q000503:physiopathology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000451:nursing / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D010865:Pilot Projects; D011446:Prospective Studies; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents