@Article{信息:doi 10.2196 / / jmir。2298，作者=“Thiboutot, Jeffrey和Sciamanna, Christopher N和Falkner, Bonita和Kephart, Donna K和Stuckey, Heather L和Adelman, Alan M和Curry, William J和Lehman, Erik B”，标题=“基于web的患者激活干预对克服临床血压控制惯性的影响:聚类随机对照试验”，期刊=“J医学互联网研究”，年=“2013”，月=“Sep”，日=“04”，量=“15”，数=“9”，页=“e158”，关键词=“高血压;互联网;tailored-feedback;背景:只有大约一半的高血压患者血压得到控制，这在很大程度上是由于初级保健提供者(pcp)在血压升高时倾向于不加强治疗。目的:本研究测试了一项旨在帮助患者在护理点提出问题以鼓励pcp适当加强血压治疗的干预措施的效果。方法:PCP及其高血压患者(N=500)通过信件招募并随机分为2个研究组:(1)干预组，患者每月使用全自动网站收到定制信息，建议询问PCP以改善血压控制的问题;(2)对照组，类似工具建议询问预防服务(如癌症筛查)的问题。基于网络的工具设计用于12个月的每个研究期间以及与pcp的预定访问之前。主要结局是两种情况下血压得到控制的患者百分比。结果:500例入组患者(干预条件:n=282; control condition: n=218), 418 (83.6{\%}) completed the 12-month follow-up visit. At baseline, 289 (61.5{\%}) of participants had controlled blood pressure. Most (411/500, 82.2{\%}) participants used the intervention during at least 6 of 12 months and 222 (62.5{\%}) reported asking questions directly from the Web-based tool. There were no group differences in asking about medication intensification and there were no differences in blood pressure control after 12 months between the intervention condition (201/282, 71.3{\%}) and control condition (143/218, 65.6{\%}; P=.27) groups. More intervention condition participants discussed having a creatinine test (92, 52.6{\%} vs 49, 35.5{\%}; P=.02) and urine protein test (81, 44.8{\%} vs 21, 14.6{\%}; P<.001), but no group differences were observed in the rate of testing. The control condition participants reported more frequent discussions about tetanus and pneumonia vaccines and reported more tetanus (30, 13.8{\%} vs 15, 5.3{\%}; P=.02) and pneumonia (25, 11.5{\%} vs 16, 5.7{\%}; P=.02) vaccinations after 12 months. Conclusions: The use of an interactive website designed to overcome clinical inertia for hypertension care did not lead to improvements in blood pressure control. Participant adherence to the intervention was high. The control intervention led to positive changes in the use of preventive services (eg, tetanus immunization) and the intervention condition led to more discussions of hypertension-relevant tests (eg, serum creatinine and urine protein). By providing patients with individually tailored questions to ask during PCP visits, this study demonstrated that participants were likely to discuss the questions with PCPs. These discussions did not, however, lead to improvements in blood pressure control. Trial Registration: ClinicalTrials.gov NCT00377208; http://clinicaltrials.gov/ct2/show/NCT00377208 (Archived by WebCite at http://www.webcitation.org/6IqWiPLon). ", issn="14388871", doi="10.2196/jmir.2298", url="//www.mybigtv.com/2013/9/e158/", url="https://doi.org/10.2196/jmir.2298", url="http://www.ncbi.nlm.nih.gov/pubmed/24004475" }