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Physician preferences for accredited online continuing medical education.

https://arctichealth.org/en/permalink/ahliterature128570
Source
J Contin Educ Health Prof. 2011;31(4):241-6
Publication Type
Article
Date
2011
Author
Kevin J Young
Julie J Kim
George Yeung
Christina Sit
Sheldon W Tobe
Author Affiliation
Department of Medicine, University of Toronto, A240 Toronto, Canada M4N 3M5.
Source
J Contin Educ Health Prof. 2011;31(4):241-6
Date
2011
Language
English
Publication Type
Article
Keywords
Accreditation
Attitude of Health Personnel
Canada
Clinical Competence
Education, Distance - methods
Education, Medical, Continuing - methods - standards
Female
Focus Groups
Humans
Hypertension
Internal Medicine - education
Internet - standards - utilization
Internship and Residency - standards
Male
Organizational Affiliation
Physician's Practice Patterns - statistics & numerical data
Physicians - psychology - statistics & numerical data
Practice Guidelines as Topic
Qualitative Research
Abstract
The need for up-to-date and high-quality continuing medical education (CME) is growing while the financial investment in CME is shrinking. Despite online technology's potential to efficiently deliver electronic CME (eCME) to large numbers of users, it has not yet displaced traditional CME. The purpose of this study was to explore what health care providers want in eCME and how they want to use it.
This was a qualitative study. Two 3-hour focus groups were held with physicians in both academic and community practices as well as trainees knowledgeable in the hypertension clinical practice guidelines with a willingness to discuss eCME. Content/thematic analysis was used to examine the data.
Three main themes emerged: credibility, content/context, and control. Credibility was the most consistent and dominant theme. Affiliations with medical organizations and accreditation were suggested as methods by which eCME can gain credibility. The content and need for discussion of the content emerged as a key pivot point between eCME and traditional CME: a greater need for discussion was linked to a preference for traditional face-to-face CME. Control over the content and how it was accessed was an emergent theme, giving learners the ability to control the depth of learning and the time spent. They valued the ability to quickly find information that was in a format (podcast, video, mobile device) that best suited their learning needs or preferences at the time.
This study provides insight into physician preferences for eCME and hypotheses that can be used to guide further research.
PubMed ID
22189987 View in PubMed
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Canadian Hypertension Education Program: the science supporting New 2011 CHEP recommendations with an emphasis on health advocacy and knowledge translation.

https://arctichealth.org/en/permalink/ahliterature133965
Source
Can J Cardiol. 2011 Jul-Aug;27(4):407-14
Publication Type
Article
Author
Norman R C Campbell
Luc Poirier
Guy Tremblay
Patrice Lindsay
Deb Reid
Sheldon W Tobe
Author Affiliation
Department of Medicine, Faculty of Medicine, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada. ncampbel@ucalgary.ca
Source
Can J Cardiol. 2011 Jul-Aug;27(4):407-14
Language
English
French
Publication Type
Article
Keywords
Antihypertensive Agents - therapeutic use
Canada
Comorbidity
Health education
Humans
Hypertension - drug therapy
Patient Advocacy
Abstract
This is a summary of the theme, key new recommendations, and supporting science of the 2011 Canadian Hypertension Education Program (CHEP). In 2011, the ACCORD trial challenged current blood pressure treatment targets for people with diabetes. After consideration of multiple factors relating to the ACCORD trial design and its reporting, the current treatment target of
PubMed ID
21641177 View in PubMed
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The 2011 Canadian Hypertension Education Program recommendations for the management of hypertension: blood pressure measurement, diagnosis, assessment of risk, and therapy.

https://arctichealth.org/en/permalink/ahliterature132607
Source
Can J Cardiol. 2011 Jul-Aug;27(4):415-433.e1-2
Publication Type
Article
Author
Doreen M Rabi
Stella S Daskalopoulou
Raj S Padwal
Nadia A Khan
Steven A Grover
Daniel G Hackam
Martin G Myers
Donald W McKay
Robert R Quinn
Brenda R Hemmelgarn
Lyne Cloutier
Peter Bolli
Michael D Hill
Thomas Wilson
Brian Penner
Ellen Burgess
Maxime Lamarre-Cliché
Donna McLean
Ernesto L Schiffrin
George Honos
Karen Mann
Guy Tremblay
Alain Milot
Arun Chockalingam
Simon W Rabkin
Martin Dawes
Rhian M Touyz
Kevin D Burns
Marcel Ruzicka
Norman R C Campbell
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Tavis S Campbell
M Patrice Lindsay
Robert J Herman
Pierre Larochelle
Ross D Feldman
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Luc Trudeau
Simon L Bacon
Robert J Petrella
Richard Lewanczuk
James A Stone
Denis Drouin
Jean-Martin Boulanger
Mukul Sharma
Pavel Hamet
George Fodor
George K Dresser
S George Carruthers
George Pylypchuk
Richard E Gilbert
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Philip A McFarlane
Robert A Hegele
Luc Poirier
Sheldon W Tobe
Author Affiliation
Department of Medicine, University of Calgary, Calgary, Alberta, Canada. doreen.rabi@albertahealthservices.ca
Source
Can J Cardiol. 2011 Jul-Aug;27(4):415-433.e1-2
Language
English
French
Publication Type
Article
Keywords
Adult
Antihypertensive Agents - therapeutic use
Blood Pressure Determination
Canada
Health education
Humans
Hypertension - diagnosis - drug therapy
Risk assessment
Abstract
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2011. The major guideline changes this year are: (1) a recommendation was made for using comparative risk analogies when communicating a patient's cardiovascular risk; (2) diagnostic testing issues for renal artery stenosis were discussed; (3) recommendations were added for the management of hypertension during the acute phase of stroke; (4) people with hypertension and diabetes are now considered high risk for cardiovascular events if they have elevated urinary albumin excretion, overt kidney disease, cardiovascular disease, or the presence of other cardiovascular risk factors; (5) the combination of an angiotensin-converting enzyme (ACE) inhibitor and a dihydropyridine calcium channel blocker (CCB) is preferred over the combination of an ACE inhibitor and a thiazide diuretic in persons with diabetes and hypertension; and (6) a recommendation was made to coordinate with pharmacists to improve antihypertensive medication adherence. We also discussed the recent analyses that examined the association between angiotensin II receptor blockers (ARBs) and cancer.
PubMed ID
21801975 View in PubMed
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The Canadian Hypertension Education Program - a unique Canadian knowledge translation program.

https://arctichealth.org/en/permalink/ahliterature163299
Source
Can J Cardiol. 2007 May 15;23(7):551-5
Publication Type
Article
Date
May-15-2007
Author
Sheldon W Tobe
Rhian M Touyz
Norm R C Campbell
Author Affiliation
Sunnybrook Health Sciences Centre, Toronto, Ontario. sheldon.tobe@sunnybrook.ca
Source
Can J Cardiol. 2007 May 15;23(7):551-5
Date
May-15-2007
Language
English
Publication Type
Article
Keywords
Canada
Databases as Topic
Humans
Hypertension - diagnosis - prevention & control
Information Dissemination
Patient Education as Topic
Practice Guidelines as Topic
Abstract
The Canadian Hypertension Education Program annually appraises data from hypertension research and updates clinical practice recommendation for the diagnosis and management of hypertension. Enormous effort is devoted to disseminating these recommendations to target groups throughout the country and, through the use of institutional databases, to evaluating their effectiveness in improving the health of Canadians by lowering blood pressure in people with hypertension. The mission of the Canadian Hypertension Education Program is to reduce the impact of hypertension on cardiovascular disease in Canada.
Notes
Cites: Hypertension. 2006 Jan;47(1):22-816344380
Cites: Can J Cardiol. 2006 May 15;22(7):595-816755314
Cites: Can J Cardiol. 2006 May 15;22(7):559-6416755310
PubMed ID
17534461 View in PubMed
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The 2012 Canadian hypertension education program recommendations for the management of hypertension: blood pressure measurement, diagnosis, assessment of risk, and therapy.

https://arctichealth.org/en/permalink/ahliterature124290
Source
Can J Cardiol. 2012 May;28(3):270-87
Publication Type
Article
Date
May-2012
Author
Stella S Daskalopoulou
Nadia A Khan
Robert R Quinn
Marcel Ruzicka
Donald W McKay
Daniel G Hackam
Simon W Rabkin
Doreen M Rabi
Richard E Gilbert
Raj S Padwal
Martin Dawes
Rhian M Touyz
Tavis S Campbell
Lyne Cloutier
Steven Grover
George Honos
Robert J Herman
Ernesto L Schiffrin
Peter Bolli
Thomas Wilson
Ross D Feldman
M Patrice Lindsay
Brenda R Hemmelgarn
Michael D Hill
Mark Gelfer
Kevin D Burns
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Donna McLean
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Jean-Martin Boulanger
Pierre Larochelle
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Janusz Kaczorowski
Luc Trudeau
Simon L Bacon
Robert J Petrella
Alain Milot
James A Stone
Denis Drouin
Maxime Lamarre-Cliché
Marshall Godwin
Guy Tremblay
Pavel Hamet
George Fodor
S George Carruthers
George Pylypchuk
Ellen Burgess
Richard Lewanczuk
George K Dresser
Brian Penner
Robert A Hegele
Philip A McFarlane
Mukul Sharma
Norman R C Campbell
Debra Reid
Luc Poirier
Sheldon W Tobe
Author Affiliation
Division of General Internal Medicine, McGill University, Montreal, Québec, Canada. stella.daskalopoulou@mcgill.ca
Source
Can J Cardiol. 2012 May;28(3):270-87
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure Determination - methods
Canada
Cardiovascular Diseases - etiology - prevention & control
Education, Medical, Continuing - standards
Evidence-Based Medicine - standards
Female
Health Education - standards
Humans
Hypertension - complications - diagnosis - therapy
Male
Middle Aged
Monitoring, Physiologic - methods
Practice Guidelines as Topic - standards
Prognosis
Risk assessment
Treatment Outcome
Abstract
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2012. The new recommendations are: (1) use of home blood pressure monitoring to confirm a diagnosis of white coat syndrome; (2) mineralocorticoid receptor antagonists may be used in selected patients with hypertension and systolic heart failure; (3) a history of atrial fibrillation in patients with hypertension should not be a factor in deciding to prescribe an angiotensin-receptor blocker for the treatment of hypertension; and (4) the blood pressure target for patients with nondiabetic chronic kidney disease has now been changed to
PubMed ID
22595447 View in PubMed
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The 2005 Canadian Hypertension Education Program recommendations for the management of hypertension: part 1- blood pressure measurement, diagnosis and assessment of risk.

https://arctichealth.org/en/permalink/ahliterature173955
Source
Can J Cardiol. 2005 Jun;21(8):645-56
Publication Type
Article
Date
Jun-2005
Author
Brenda R Hemmelgarn
Finlay A McAllister
Martin G Myers
Donald W McKay
Peter Bolli
Carl Abbott
Ernesto L Schiffrin
Steven Grover
George Honos
Marcel Lebel
Karen Mann
Thomas Wilson
Brian Penner
Guy Tremblay
Sheldon W Tobe
Ross D Feldman
Author Affiliation
Division of Nephrology, University of Calgary, Calgary, Canada.
Source
Can J Cardiol. 2005 Jun;21(8):645-56
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Blood Pressure Monitoring, Ambulatory
Canada
Decision Trees
Evidence-Based Medicine
Humans
Hypertension - diagnosis - prevention & control
Patient Education as Topic
Risk assessment
Abstract
To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with high blood pressure (BP).
For persons in whom a high BP value is recorded, the assignment of a diagnosis of hypertension is dependent on the appropriate measurement of BP, the level of the BP elevation and the duration of follow-up. In addition, the presence of cardiovascular risk factors and target organ damage should be assessed to determine the urgency, intensity and type of treatment. For persons diagnosed as having hypertension, estimating overall risk of adverse cardiovascular outcomes requires an assessment of other vascular risk factors and hypertensive target organ damage.
MEDLINE searches were conducted from November 2003 to October 2004 to update the 2004 recommendations. Reference lists were scanned, experts were polled, and the personal files of the authors and subgroup members were used to identify other studies. Identified articles were reviewed and appraised using prespecified levels of evidence by content and methodological experts. As per previous years, only studies that had been published in the peer-reviewed literature were included; evidence from abstracts, conference presentations and unpublished personal communications was not included.
This document contains recommendations for BP measurement, diagnosis of hypertension and assessment of cardiovascular risk for adults with high BP. These include the accurate measurement of BP, criteria for diagnosis of hypertension, and recommendations for follow-up, assessment of overall cardiovascular risk, routine and optional laboratory testing, assessment for renovascular and endocrine causes, home and ambulatory BP monitoring, and the role of echocardiography for those with hypertension. Key features of the 2005 recommendations include an expedited diagnostic algorithm for hypertension and an endorsement of the use of home/self and ambulatory BP assessment as validated techniques in establishing the diagnosis of hypertension.
All recommendations were graded according to the strength of the evidence and voted on by the 43 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported in the present paper received at least 95% consensus. These guidelines will continue to be updated annually.
PubMed ID
16003448 View in PubMed
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The 2007 Canadian Hypertension Education Program recommendations for the management of hypertension: part 1- blood pressure measurement, diagnosis and assessment of risk.

https://arctichealth.org/en/permalink/ahliterature163301
Source
Can J Cardiol. 2007 May 15;23(7):529-38
Publication Type
Conference/Meeting Material
Article
Date
May-15-2007
Author
Raj S Padwal
Brenda R Hemmelgarn
Finlay A McAlister
Donald W McKay
Steven Grover
Thomas Wilson
Brian Penner
Ellen Burgess
Peter Bolli
Michael Hill
Jeff Mahon
Martin G Myers
Carl Abbott
Ernest L Schiffrin
George Honos
Karen Mann
Guy Tremblay
Alain Milot
Lyne Cloutier
Arun Chockalingam
Nadia A Khan
Simon W Rabkin
Martin Dawes
Rhian M Touyz
Sheldon W Tobe
Author Affiliation
Division of General Internal Medicine, University of Alberta, Edmonton, Alberta. rpadwal@ualberta.ca
Source
Can J Cardiol. 2007 May 15;23(7):529-38
Date
May-15-2007
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Blood Pressure Determination
Blood Pressure Monitoring, Ambulatory
Canada
Health promotion
Humans
Hypertension - diagnosis - physiopathology - prevention & control
Patient Education as Topic
Risk factors
Abstract
To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with hypertension.
The diagnosis of hypertension is dependent on the appropriate measurement of blood pressure, the timely assessment of serially elevated readings, the degree of blood pressure elevation, the method of measurement (office, ambulatory, home) and any associated comorbidities. The presence of cardiovascular risk factors and target organ damage should be ascertained to assess global cardiovascular risk, and to determine the urgency, intensity and type of treatment required.
MEDLINE searches were conducted from November 2005 to October 2006 with the aid of a medical librarian. Reference lists were scanned, experts were contacted, and the personal files of authors and subgroup members were used to identify additional studies. Content and methodological experts assessed studies using prespecified, standardized evidence-based algorithms. Recommendations were based on evidence from peer-reviewed, full-text articles only.
Recommendations for blood pressure measurement, criteria for hypertension diagnosis and follow-up, assessment of global cardiovascular risk, diagnostic testing, diagnosis of renovascular and endocrine causes of hypertension, home and ambulatory monitoring, and the use of echocardiography in hypertensive individuals are outlined. Key messages in 2007 include continued emphasis on the expedited, accurate diagnosis of hypertension, the importance of assessing the risk of cerebrovascular events as part of global risk assessment, the need for ongoing reassessment of patients with high normal blood pressure, and reviews of recent studies involving laboratory testing and home monitoring.
All recommendations were graded according to strength of the evidence and were voted on by the 57 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here received at least 70% consensus. These guidelines will continue to be updated annually.
Notes
Cites: Lancet. 2001 Nov 17;358(9294):1682-611728544
Cites: Clin Sci (Lond). 2001 Dec;101(6):671-911724655
Cites: J Hypertens. 2002 Apr;20(4):579-8111910284
Cites: Stroke. 2002 Jul;33(7):1776-8112105351
Cites: Can J Cardiol. 2002 Jun;18(6):604-2412107419
Cites: Can J Cardiol. 2002 Jun;18(6):625-4112107420
Cites: Blood Press Monit. 2002 Dec;7(6):293-30012488648
Cites: Lancet. 2002 Dec 14;360(9349):1903-1312493255
Cites: Eur Heart J. 2003 Jun;24(11):987-100312788299
Cites: Hypertension. 2004 Jan;43(1):10-714638619
Cites: Can J Cardiol. 2004 Jan;20(1):31-4014968141
Cites: Can J Cardiol. 2004 Jan;20(1):41-5414968142
Cites: JAMA. 2004 Mar 17;291(11):1342-915026401
Cites: Lancet. 2004 Sep 11-17;364(9438):937-5215364185
Cites: Circulation. 1991 Jan;83(1):356-621984895
Cites: JAMA. 1996 May 22-29;275(20):1571-68622248
Cites: Arch Intern Med. 1996 Jul 8;156(13):1414-208678709
Cites: Arch Intern Med. 1998 Mar 23;158(6):655-629521231
Cites: Am J Epidemiol. 2004 Dec 1;160(11):1122-3115561992
Cites: Can J Cardiol. 2005 Jun;21(8):645-5616003448
Cites: Can J Cardiol. 2005 Jun;21(8):657-7216003449
Cites: Arch Intern Med. 2005 Jul 11;165(13):1541-616009871
Cites: Kidney Int. 2006 Jan;69(2):406-1116408134
Cites: J Hypertens. 2006 Apr;24(4):775-8116531808
Cites: N Engl J Med. 2006 Apr 20;354(16):1685-9716537662
Cites: Hypertension. 2006 May;47(5):846-5316567588
Cites: Can J Cardiol. 2006 May 15;22(7):559-6416755310
Cites: Can J Cardiol. 2006 May 15;22(7):573-8116755312
Cites: Can J Cardiol. 2006 May 15;22(7):583-9316755313
Cites: Can J Cardiol. 2006 May 15;22(7):606-1316755316
Cites: Am J Epidemiol. 2006 Oct 15;164(8):725-716936069
Cites: Lancet. 2003 Nov 29;362(9398):1776-714654312
Cites: Can J Cardiol. 2001 Dec;17(12):1249-6311773936
Cites: Am Heart J. 2000 Feb;139(2 Pt 1):272-8110650300
Cites: Arch Intern Med. 2000 Mar 13;160(5):685-9310724055
Cites: Clin Radiol. 2000 May;55(5):346-5310816399
Cites: Can J Cardiol. 2000 Sep;16(9):1094-10211021953
Cites: BMJ. 2001 Apr 21;322(7292):977-8011312234
Cites: Can J Cardiol. 2001 May;17(5):543-5911381277
Cites: JAMA. 2001 Jul 11;286(2):180-711448281
Cites: N Engl J Med. 2001 Nov 1;345(18):1291-711794147
Comment In: Can J Cardiol. 2007 May 15;23(7):603-417593584
PubMed ID
17534459 View in PubMed
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The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part I--Blood pressure measurement, diagnosis and assessment of risk.

https://arctichealth.org/en/permalink/ahliterature168977
Source
Can J Cardiol. 2006 May 15;22(7):573-81
Publication Type
Article
Date
May-15-2006
Author
B R Hemmelgarn
Finlay A McAlister
Steven Grover
Martin G Myers
Donald W McKay
Peter Bolli
Carl Abbott
Ernesto L Schiffrin
George Honos
Ellen Burgess
Karen Mann
Thomas Wilson
Brian Penner
Guy Tremblay
Alain Milot
Arun Chockalingam
Rhian M Touyz
Sheldon W Tobe
Author Affiliation
Division of Nephrology, University of Calgary, and Foothills Hospital, 1403 29th Street Northwest, Calgary, Alberta, Canada. brenda.hemmelgarn@calgaryhealthregion.ca
Source
Can J Cardiol. 2006 May 15;22(7):573-81
Date
May-15-2006
Language
English
Publication Type
Article
Keywords
Advisory Committees
Blood Pressure Determination
Canada
Echocardiography
Humans
Hyperaldosteronism - diagnosis
Hypertension - diagnosis
Mass Screening
Patient Education as Topic
Pheochromocytoma - diagnosis
Risk assessment
Risk factors
Abstract
To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with high blood pressure.
For persons in whom a high blood pressure value is recorded, a diagnosis of hypertension is dependent on the appropriate measurement of blood pressure, the level of the blood pressure elevation, the approach used to monitor blood pressure (office, ambulatory or home/self), and the duration of follow-up. In addition, the presence of cardiovascular risk factors and target organ damage should be assessed to determine the urgency, intensity and type of treatment. For persons diagnosed as having hypertension, estimating the overall risk of adverse cardiovascular outcomes requires an assessment for other vascular risk factors and hypertensive target organ damage.
MEDLINE searches were conducted from November 2004 to October 2005 to update the 2005 recommendations. Reference lists were scanned, experts were polled, and the personal files of the authors and subgroup members were used to identify other studies. Identified articles were reviewed and appraised using prespecified levels of evidence by content and methodological experts. As per previous years, the authors only included studies that had been published in the peer-reviewed literature and did not include evidence from abstracts, conference presentations or unpublished personal communications.
The present document contains recommendations for blood pressure measurement, diagnosis of hypertension, and assessment of cardiovascular risk for adults with high blood pressure. These include the accurate measurement of blood pressure, criteria for the diagnosis of hypertension and recommendations for follow-up, assessment of overall cardiovascular risk, routine and optional laboratory testing, assessment for renovascular and endocrine causes, home and ambulatory blood pressure monitoring, and the role of echocardiography for those with hypertension. Key features of the 2006 recommendations include continued emphasis on an expedited diagnosis of hypertension, an in-depth review of the role of global risk assessment in hypertension therapy, and the use of home/self blood pressure monitoring for patients with masked hypertension (subjects with hypertension who have a blood pressure that is normal in clinic but elevated on home/self measurement).
All recommendations were graded according to the strength of the evidence and were voted on by the 45 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported herein received at least 95% consensus. These guidelines will continue to be updated annually.
Notes
Cites: Can J Cardiol. 2002 Jun;18(6):625-4112107420
Cites: CMAJ. 2005 Aug 30;173(5):480-316129865
Cites: Can J Cardiol. 2001 May;17(5):543-5911381277
Cites: JAMA. 2001 Jul 11;286(2):180-711448281
Cites: Am J Hypertens. 2001 Nov;14(11 Pt 1):1099-10511724207
Cites: Clin Sci (Lond). 2001 Dec;101(6):671-911724655
Cites: Can J Cardiol. 2001 Dec;17(12):1249-6311773936
Cites: Am Heart J. 2000 Feb;139(2 Pt 1):272-8110650300
Cites: Can J Cardiol. 2000 Sep;16(9):1094-10211021953
Cites: BMJ. 2001 Apr 21;322(7292):977-8011312234
Cites: J Hypertens. 2002 Apr;20(4):579-8111910284
Cites: Stroke. 2002 Jul;33(7):1776-8112105351
Cites: Can J Cardiol. 2002 Jun;18(6):604-2412107419
Cites: Eur Heart J. 2003 Jun;24(11):987-100312788299
Cites: Lancet. 2003 Nov 29;362(9398):1776-714654312
Cites: Can J Cardiol. 2004 Jan;20(1):31-4014968141
Cites: Can J Cardiol. 2004 Jan;20(1):41-5414968142
Cites: JAMA. 2004 Mar 17;291(11):1342-915026401
Cites: Intern Med J. 2004 May;34(5):290-115151677
Cites: Lancet. 2004 Sep 11-17;364(9438):937-5215364185
Cites: J Hum Hypertens. 2004 Nov;18(11):769-7315141270
Cites: Circulation. 1991 Jan;83(1):356-621984895
Cites: JAMA. 1996 May 22-29;275(20):1571-68622248
Cites: Arch Intern Med. 1996 Jul 8;156(13):1414-208678709
Cites: Arch Intern Med. 1998 Mar 23;158(6):655-629521231
Cites: JAMA. 2004 Nov 17;292(19):2350-615547162
Cites: Am J Hypertens. 2005 Jun;18(6):772-815925734
Cites: Can J Cardiol. 2005 Jun;21(8):645-5616003448
Cites: Can J Cardiol. 2005 Jun;21(8):657-7216003449
Cites: Blood Press Monit. 2002 Dec;7(6):293-30012488648
PubMed ID
16755312 View in PubMed
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Heart and Stroke Foundation of Ontario (HSFO) high blood pressure strategy's hypertension management initiative study protocol.

https://arctichealth.org/en/permalink/ahliterature153798
Source
BMC Health Serv Res. 2008;8:251
Publication Type
Article
Date
2008
Author
Sheldon W Tobe
Margaret Moy Lum-Kwong
Nancy Perkins
Shirley Von Sychowski
Rolf J Sebaldt
Alex Kiss
Author Affiliation
Division of Nephrology, Suite A240, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada. sheldon.tobe@sunnybrook.ca
Source
BMC Health Serv Res. 2008;8:251
Date
2008
Language
English
Publication Type
Article
Keywords
Humans
Hypertension - drug therapy
Nurses
Ontario
Patient care team
Patient Education as Topic
Pharmacists
Physician-Patient Relations
Physicians, Family
Primary Health Care
Risk Reduction Behavior
Self Care
Abstract
Achieving control of hypertension prevents target organ damage at both the micro and macrovascular level and is a highly cost effective means of lowering the risk for heart attack and stroke particularly in people with diabetes. Clinical trials demonstrate that blood pressure control can be achieved in a large proportion of people. Translating this knowledge into widespread practice is the focus of the Hypertension Management Initiative, which began in 2004 with the goal of improving the management of this chronic health condition by primary care providers and patients in the community.
This study will test the effect of a systems change on the management of high blood pressure in real world practice in primary care in Ontario, Canada. The systems change intervention involves an interprofessional educational program bringing together physicians, nurses and pharmacists with tools for both providers and patients to facilitate blood pressure management. Each of two waves of subjects were enrolled over a 6 month period with the initial enrollment between waves separated by 9 months. Blood pressure will be measured with the BpTru automated blood pressure device. To determine the effectiveness of the intervention, a before and after analysis within all subjects will compare blood pressure at baseline to annual measurements for the three year study. To assess whether the intervention has an impact on blood pressure control independent of community trends, a betwen group comparison of baseline blood pressures in the delayed wave will be made with the immediate wave during the same time period, so that the immediate wave has experienced the intervention for at least 9 months. The total enrollment goal is 5,000 subjects. The practice locations include 10 Family Health Teams (FHTs) and 1 Community Health Centre (CHC) and approximately 49 primary care physicians, 15 nurse practitioners, 37 registered nurses and over 150 community pharmacists across the 11 communities throughout the province of Ontario. The 11 primary care sites will be divided into immediate and delayed groups based on geography and the use of an electronic versus a traditional chart patient record.
Initial consideration was given to randomizing the groups, however, for a number of reasons, this was deemed to not be possible. In order to ensure that the sites in the immediate intervention and delayed intervention groups are not different from each other, the sites will be assigned to the intervention groups manually to ensure a distribution of the variables as evenly as possible. Given that HSFO approached this particular group of health care providers to participate in a program relating to hypertension, this may have heightened their awareness of the issue and affected their management of patients with hypertension. Thus, data will be collected to allow an assessment of previous practice patterns and determine any impact of the Hawthorne Effect.
Clinicaltrials.gov NCT00425828.
Notes
Cites: Am J Hypertens. 2001 Nov;14(11 Pt 1):1099-10511724207
Cites: CMAJ. 1992 Jun 1;146(11):1997-20051596849
Cites: Can J Cardiol. 2007 May 15;23(7):539-5017534460
Cites: Blood Press Monit. 2004 Feb;9(1):47-5215021078
PubMed ID
19068141 View in PubMed
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18 records – page 1 of 2.