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The devil is in the detail - a multifactorial intervention to reduce blood pressure in co-existing diabetes and chronic kidney disease: a single blind, randomized controlled trial

Williams, Allison F., Manias, Elizabeth and Walker, Rowan G. 2010, The devil is in the detail - a multifactorial intervention to reduce blood pressure in co-existing diabetes and chronic kidney disease: a single blind, randomized controlled trial, BMC family practice, vol. 11, pp. 1-9, doi: 10.1186/1471-2296-11-3.

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Title The devil is in the detail - a multifactorial intervention to reduce blood pressure in co-existing diabetes and chronic kidney disease: a single blind, randomized controlled trial
Author(s) Williams, Allison F.
Manias, ElizabethORCID iD for Manias, Elizabeth orcid.org/0000-0002-3747-0087
Walker, Rowan G.
Journal name BMC family practice
Volume number 11
Article ID 3
Start page 1
End page 9
Total pages 9
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2010-01-12
ISSN 1471-2296
Keyword(s) Adult
Comorbidity
Diabetes Complications
Disease Management
Female
Health Behavior
Humans
Hypertension
Kidney Diseases
Male
Outcome Assessment (Health Care)
Patient Care Team
Patient Compliance
Self Care
Single-Blind Method
Summary BACKGROUND: About 30-60% of individuals are non-adherent to their prescribed medications and this risk increases as the number of prescribed medications increases. This paper outlines the development of a consumer-centred Medicine Self-Management Intervention (MESMI), designed to improve blood pressure control and medication adherence in consumers with diabetes and chronic kidney disease recruited from specialist outpatients' clinics.

METHODS: We developed a multifactorial intervention consisting of Self Blood Pressure Monitoring (SBPM), medication review, a twenty-minute interactive Digital Versatile Disc (DVD), and follow-up support telephone calls to help consumers improve their blood pressure control and take their medications as prescribed. The intervention is novel in that it has been developed from analysis of consumer and health professional views, and includes consumer video exemplars in the DVD. The primary outcome measure was a drop of 3-6 mmHg systolic blood pressure at three months after completion of the intervention. Secondary outcome measures included: assessment of medication adherence, medication self-efficacy and general wellbeing. Consumers' adherence to their prescribed medications was measured by manual pill count, self-report of medication adherence, and surrogate biochemical markers of disease control.

DISCUSSION: The management of complex health problems is an increasing component of health care practice, and requires interventions that improve patient outcomes. We describe the preparatory work and baseline data of a single blind, randomized controlled trial involving consumers requiring cross-specialty care with a follow-up period extending to 12 months post-baseline.
Language eng
DOI 10.1186/1471-2296-11-3
Field of Research 1117 Public Health And Health Services
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2010, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30073482

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.