社区管理和人工干预.doc

Display Settings: ? Abstract Send to: BMC Health Serv Res. 2012 Jul 24;12:216. Effectiveness of interventions for hypertension care in the community - a meta-analysis of controlled studies in China. Lu Z, Cao S, Chai Y, Liang Y, Bachmann M, Suhrcke M, Song F. Source Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, Norfolk, UK. Fujian.song@uea.ac.uk. Abstract ABSTRACT: BACKGROUND: Hypertension is a serious public health problem in China and in other developing countries. Our aim is to conduct a systematic review of studies on the effectiveness of community interventions for hypertension management in China. METHODS: China National Knowledge Infrastructure, PubMed, and references of retrieved articles were searched to identify randomised or quasi-randomised controlled studies that evaluated community hypertension care in mainland China. One reviewer extracted and a second reviewer checked data from the included studies. RESULTS: We included 94 studies, 93 of which were in Chinese language, that evaluated the following interventions: health education, improved monitoring, family-support, self-management, healthcare management changes and training of providers. The study quality was generally poor, with high risk of biased outcome reporting and significant heterogeneity between studies. When reported, the vast majority of the included studies reported statistically significantly improved outcomes in the intervention group. By assuming zero treatment effects for missing outcomes, the weighted reduction in the intervention group was 6?9 (95% CI: 4?9 to 8?9) mm Hg for systolic BP, and 3?8 (95% CI: 2?6 to 5?0) mm Hg for diastolic BP. Exploratory subgroup analyses found no significant differences between different interventions. CONCLUSIONS: After taking account of possible reporting biases, a wide range of community interventions for hypertension care remain effective. The findings have implications for China and other l