The effect of a hypertension self-management intervention on diabetes and cholesterol control.

Published

Journal Article

Most patient chronic disease self-management interventions target single-disease outcomes. We evaluated the effect of a tailored hypertension self-management intervention on the unintended targets of glycosylated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C).We evaluated patients from the Veterans Study to Improve the Control of Hypertension, a 2-year randomized controlled trial. Patients received either a hypertension self-management intervention delivered by a nurse over the telephone or usual care. Although the study focused on hypertension self-management, we compared changes in HbA1c among a subgroup of 216 patients with diabetes and LDL-C among 528 patients with measurements during the study period. Changes in these laboratory values over time were compared between the 2 treatment groups using linear mixed-effects models.For the patients with diabetes, the hypertension self-management intervention resulted in a 0.46% reduction in HbA1c over 2 years compared with usual care (95% confidence interval, 0.04%-0.89%; P = .03). For LDL-C, there was a minimal 0.9 mg/dL between-group difference that was not statistically significant (95% confidence interval, -7.3-5.6 mg/dL; P = .79).There was a significant effect of the self-management intervention on the unintended target of HbA1c, but not LDL-C. Chronic disease self-management interventions might have "spill-over" effects on patients' comorbid chronic conditions.

Full Text

Duke Authors

Cited Authors

  • Powers, BJ; Olsen, MK; Oddone, EZ; Bosworth, HB

Published Date

  • July 2009

Published In

Volume / Issue

  • 122 / 7

Start / End Page

  • 639 - 646

PubMed ID

  • 19559166

Pubmed Central ID

  • 19559166

Electronic International Standard Serial Number (EISSN)

  • 1555-7162

International Standard Serial Number (ISSN)

  • 0002-9343

Digital Object Identifier (DOI)

  • 10.1016/j.amjmed.2008.12.022

Language

  • eng