Effectiveness of interventions for hypertension care in the community - a meta-analysis of controlled studies in China

Lu, Z, Cao, S, Chai, Y, Liang, Yuan, Bachmann, M, Suhrcke, M and Song, F (2012) Effectiveness of interventions for hypertension care in the community - a meta-analysis of controlled studies in China. BMC Health Services Research, 12. ISSN 1472-6963

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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 low and middle income countries facing similar challenges. Because of significant heterogeneity and high risk of bias in the available studies, further well designed studies should be conducted in China to provide high quality evidence to inform policy decisions on hypertension control.

Item Type: Article
Uncontrolled Keywords: hypertension,quality of hypertension care,community-based interventions,primary care,low and middle income countries,systematic review
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Users 2731 not found.
Date Deposited: 13 Aug 2012 16:46
Last Modified: 23 Jan 2019 12:31
URI: https://ueaeprints.uea.ac.uk/id/eprint/39338
DOI: 10.1186/1472-6963-12-216

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