title: Home-based interventions for black patients with uncontrolled hypertension: a cluster randomized controlled trial.
abstract: OBJECTIVE
  Assess the comparative effectiveness of two blood pressure (BP) control interventions for black patients with uncontrolled hypertension.
  
  
  METHODS
  A total of 845 patients were enrolled in a three-arm cluster randomized trial. On admission of an eligible patient, field nurses were randomized to usual care, a basic or augmented intervention.
  
  
  RESULTS
  Across study arms there were no significant 12 months differences in BP control rates (primary outcome) (25% usual care, 26% basic intervention, 22% augmented intervention); systolic BP (143.8 millimeters of mercury [mmHg], 146.9 mmHG, 143.9 mmHG, respectively); medication intensification (47, 43, 54%, respectively); or self-management score (18.7, 18.7, 17.9, respectively). Adjusted systolic BP dropped more than 10 mmHg from baseline to 12 months (155.5-145.4 mmHg) among all study participants.
  
  
  CONCLUSIONS
  Neither the augmented nor basic intervention was more effective than usual care in improving BP control, systolic BP, medication intensification or patient self-management. Usual home care yielded substantial improvements, creating a high comparative effectiveness threshold.
  
  
  BACKGROUND
  NCT00139490.
authors.affiliation: Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY 10021, USA.
authors.forename: Penny H
authors.initials: PH
authors.lastname: Feldman
authors.affiliation: Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY 10021, USA.
authors.forename: Margaret V
authors.initials: MV
authors.lastname: McDonald
authors.affiliation: Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY 10021, USA.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Barrón
authors.affiliation: Department Healthcare Policy & Research, Weill Cornell Medical College, New York, NY 10065, USA.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Gerber
authors.affiliation: Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY 10021, USA.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Peng
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D016000:Cluster Analysis; D057186:Comparative Effectiveness Research / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009518:New York; D011446:Prospective Studies; D012648:Self Care / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents
keywords: blood pressure; comparative effectiveness; home care; hypertension; nurse-led interventions