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Article: Delivery of care for hypertension

TitleDelivery of care for hypertension
Authors
Issue Date1995
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/jhh
Citation
Journal Of Human Hypertension, 1995, v. 9 n. 6, p. 429-433 How to Cite?
AbstractTo overcome shortcomings in the delivery of care for hypertension various approaches have been developed including a system whereby care of hypertension is shared in a formal manner between general practitioners and hospital specialists. The feasibility, acceptability and cost-effectiveness of a computerised model of shared care were investigated in three matched groups of patients attending hypertension clinics in Glasgow. Glasgow Blood Pressure Clinic attenders considered suitable for shared care by their consultants were randomised to shared care (n = 277) or continued clinic follow-up; a further control group (n = 277) was identified from an independent nurse-practitioner clinic. After 2 years of follow-up, feasibility was estimated by the proportion of patients who had undergone an adequate review (blood pressure, serum creatinine and electrocardiograph); acceptability to general practitioners and patients was assessed by questionnaires; cost-effectiveness was calculated as the cost (to National Health Service and patient) per adequate review. The drop-out rate for shared care over 2 years was 3% compared with 14% for the outpatient clinic and 9% for the nurse-practitioner clinic. In year 2, rates of adequate reviews were 82%, 52% and 75%, respectively. Blood pressure control was similar in the groups. Of 297 general practitioners invited to participate, 85% agreed and 68% wished to continue participation after 2 years. About 50% of shared care patients preferred this method of follow-up compared with their earlier experience of clinic attendance. Shared care was more cost-effective than either conventional or nurse-practitioner clinic follow-up, especially with respect to cost to the patient; costs per adequate review (£sterling) were 28.96, 50.55 and 30.95, respectively. These findings indicate that shared care is a feasible, acceptable and cost-effective method of long-term follow-up for hypertensive patients. Shared care is one approach which may improve the delivery of care for hypertension.
Persistent Identifierhttp://hdl.handle.net/10722/86444
ISSN
2015 Impact Factor: 2.833
2015 SCImago Journal Rankings: 1.167
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMcInnes, GTen_HK
dc.contributor.authorMcGhee, SMen_HK
dc.date.accessioned2010-09-06T09:17:07Z-
dc.date.available2010-09-06T09:17:07Z-
dc.date.issued1995en_HK
dc.identifier.citationJournal Of Human Hypertension, 1995, v. 9 n. 6, p. 429-433en_HK
dc.identifier.issn0950-9240en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86444-
dc.description.abstractTo overcome shortcomings in the delivery of care for hypertension various approaches have been developed including a system whereby care of hypertension is shared in a formal manner between general practitioners and hospital specialists. The feasibility, acceptability and cost-effectiveness of a computerised model of shared care were investigated in three matched groups of patients attending hypertension clinics in Glasgow. Glasgow Blood Pressure Clinic attenders considered suitable for shared care by their consultants were randomised to shared care (n = 277) or continued clinic follow-up; a further control group (n = 277) was identified from an independent nurse-practitioner clinic. After 2 years of follow-up, feasibility was estimated by the proportion of patients who had undergone an adequate review (blood pressure, serum creatinine and electrocardiograph); acceptability to general practitioners and patients was assessed by questionnaires; cost-effectiveness was calculated as the cost (to National Health Service and patient) per adequate review. The drop-out rate for shared care over 2 years was 3% compared with 14% for the outpatient clinic and 9% for the nurse-practitioner clinic. In year 2, rates of adequate reviews were 82%, 52% and 75%, respectively. Blood pressure control was similar in the groups. Of 297 general practitioners invited to participate, 85% agreed and 68% wished to continue participation after 2 years. About 50% of shared care patients preferred this method of follow-up compared with their earlier experience of clinic attendance. Shared care was more cost-effective than either conventional or nurse-practitioner clinic follow-up, especially with respect to cost to the patient; costs per adequate review (£sterling) were 28.96, 50.55 and 30.95, respectively. These findings indicate that shared care is a feasible, acceptable and cost-effective method of long-term follow-up for hypertensive patients. Shared care is one approach which may improve the delivery of care for hypertension.en_HK
dc.languageengen_HK
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/jhhen_HK
dc.relation.ispartofJournal of Human Hypertensionen_HK
dc.subject.meshDelivery of Health Care - methodsen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHealth Care Costsen_HK
dc.subject.meshHumansen_HK
dc.subject.meshHypertension - therapyen_HK
dc.subject.meshLongitudinal Studiesen_HK
dc.subject.meshNurse Practitionersen_HK
dc.subject.meshPatient Acceptance of Health Careen_HK
dc.subject.meshPersonnel, Hospitalen_HK
dc.subject.meshPhysicians, Familyen_HK
dc.subject.meshTherapy, Computer-Assisteden_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleDelivery of care for hypertensionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0950-9240&volume=9&spage=429&epage=433&date=1995&atitle=Delivery+of+care+for+hypertensionen_HK
dc.identifier.emailMcGhee, SM:smmcghee@hkucc.hku.hken_HK
dc.identifier.authorityMcGhee, SM=rp00393en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid7473523-
dc.identifier.scopuseid_2-s2.0-0029052134en_HK
dc.identifier.hkuros8953en_HK
dc.identifier.volume9en_HK
dc.identifier.issue6en_HK
dc.identifier.spage429en_HK
dc.identifier.epage433en_HK
dc.identifier.isiWOS:A1995RE76000012-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridMcInnes, GT=18735269900en_HK
dc.identifier.scopusauthoridMcGhee, SM=7003288588en_HK

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