title: Effectiveness of multidisciplinary intervention on blood pressure control in primary health care: a randomized clinical trial.
abstract: Hypertension is a public health problem and a major risk factor for cardiovascular disease. The purpose of this study is to compare the effectiveness of a multidisciplinary program based on group and individual care versus group-only care, to promote blood pressure control in hypertensive patients in primary health care.
  
  
  
  Randomized controlled clinical trial. The study was conducted within the primary health care, in two units of the Family Health Strategy, covering 11,000 individuals, in Porto Alegre, Brazil. Two hundred and 56 patients, older than 40 years old and with uncontrolled hypertension, systolic blood pressure (BP) ≥140 mmHg and/or diastolic BP ≥90 mmHg or ≥130 mmHg and/or diastolic BP ≥80 mmHg for individuals with diabetes. Eligible patients were randomly assigned to a health care program aiming for blood pressure control, with the multidisciplinary program group or with the multidisciplinary program plus personalized care group. Primary outcome measures were reduction in systolic BP from baseline to 6 months. Secondary measures included proportion of patients with systolic or diastolic BP controlled. Student t test, Pearson's chi-squared test, Fisher's exact test, Mann-Whitney U test, Wilcoxon signed-ranks test and generalized estimating equation (GEE) model were used in the analysis.
  
  
  
  The baseline characteristics of participants were similar between groups. After 6 months of follow-up, systolic BP decreased markedly in both groups (Δ - 11.8 mmHg [SD, 20.2] in the multidisciplinary program group and Δ - 12.9 mmHg [SD, 19.2] in the personalized care group; p < 0.001). Similarly, we noted a significant change in diastolic BP over time in both groups (Δ - 8.1 mmHg [SD, 10.8] in the multidisciplinary program group and Δ - 7.0 mmHg [SD, 11.5] in the personalized care group; p < 0.001).
  
  
  
  The study demonstrates similar effectiveness of a group intervention in comparison to a personalized education program in hypertension patients to achieve BP control. These findings indicate that the intervention can be for all hypertensive patients assisted in primary health care.
  
  
  
  ClinicalTrials.gov Identifier NCT01696318 (May 2013).
authors: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. reginakuhmmer@gmail.com.|Graduate Program in Cardiology and Cardiovascular Science, Universidade Federal do Rio Grande do Sul. National Institute for Health Technology Assessment - IATS/CNPq, Porto Alegre, Brazil. reginakuhmmer@gmail.com.
authors: Regina
authors: R
authors: Kuhmmer
authors: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil.|Graduate Program in Cardiology and Cardiovascular Science, Universidade Federal do Rio Grande do Sul. National Institute for Health Technology Assessment - IATS/CNPq, Porto Alegre, Brazil.
authors: Rosmeri Kuhmmer
authors: RK
authors: Lazzaretti
authors: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil.
authors: Cátia Moreira
authors: CM
authors: Guterres
authors: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil.|Department of Public Health, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
authors: Fabiana Viegas
authors: FV
authors: Raimundo
authors: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil.
authors: Leni Everson Araújo
authors: LE
authors: Leite
authors: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil.
authors: Tássia Scholante
authors: TS
authors: Delabary
authors: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil.
authors: Suhelen
authors: S
authors: Caon
authors: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil.|Department of Public Health, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
authors: Gisele Alsina Nader
authors: GA
authors: Bastos
authors: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil.|Graduate Program in Cardiology and Cardiovascular Science, Universidade Federal do Rio Grande do Sul. National Institute for Health Technology Assessment - IATS/CNPq, Porto Alegre, Brazil.
authors: Carisi Anne
authors: CA
authors: Polanczyk
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001938:Brazil; D005260:Female; D006282:Health Personnel / Q000193:education; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010353:Patient Education as Topic; D057285:Precision Medicine; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration; D012307:Risk Factors
keywords: Diabetes Mellitus; Diastolic blood pressure; Hypertension; Multidisciplinary program; Public health; Systolic blood pressure