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Community-based cardiovascular Risk Factors Intervention Strategies (CORFIS) in managing hypertension: A pragmatic non-randomised controlled trial

Low WHH 1 , Seet W 2 , Ramli AS 3 , Ng KK 4 , Jamaiyah H 5 , Dan SP 6 Show all authors , Teng CL 7 , Lee VKM 8 , Chua SS 9 , Faridah Aryani MY 10 , Karupaiah T 11 , Chee WSS 12 , Goh PP 13 , Zaki M 14 , Lim TO 15

Affiliations 

  • 1 Low W H H. Clinical Research Center, Clinical Epidemiology Unit, 1st Floor MMA House, 124, Jalan Pahang, Kuala Lumpur 53000 Malaysia.
  • 2 Wymen Seet. Clinical Research Center, Clinical Epidemiology Unit, 1st Floor MMA House, 124, Jalan Pahang, Kuala Lumpur, Kuala Lumpur 53000 Malaysia. wymenseet@gmail.com
  • 3 A S Ramli. Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
  • 4 Ng K K. Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
  • 5 H Jamaiyah. Clinical Research Centre, Ministry of Health, Kuala Lumpur, Malaysia.
  • 6 Dan S P. Clinical Research Centre, Ministry of Health, Kuala Lumpur, Malaysia.
  • 7 Teng Cheong Lieng. International Medical University Malaysia, Bukit Jalil, Kuala Lumpur, Malaysia.
  • 8 Lee V K M. International Medical University Malaysia, Bukit Jalil, Kuala Lumpur, Malaysia.
  • 9 Chua S S. Universiti Malaya, Kuala Lumpur, Malaysia.
  • 10 M Y Faridah Aryani. Clinical Research Centre, Ministry of Health, Kuala Lumpur, Malaysia.
  • 11 Tilakavati Karupaiah, Universiti Kebangsaan Malaysia, Cheras, Selangor, Malaysia.
  • 12 Chee W S S. International Medical University Malaysia, Bukit Jalil, Kuala Lumpur, Malaysia.
  • 13 Goh P P. Clinical Research Centre, Ministry of Health, Kuala Lumpur, Malaysia.
  • 14 Morad Zaki. International Medical University Malaysia, Bukit Jalil, Kuala Lumpur, Malaysia.
  • 15 Lim T O. Clinical Research Centre, Ministry of Health, Kuala Lumpur, Malaysia.
Med J Malaysia, 2013 Apr;68(2):129-35.
PMID: 23629558 MyJurnal

Abstract

BACKGROUND: Hypertension is the number one cardiovascular risk factor in Malaysia. This study aimed to evaluate the effectiveness of a Community-Based Cardiovascular Risk Factors Intervention Strategies (CORFIS) in the management of hypertension in primary care.
METHODS: This is a pragmatic, non-randomized controlled trial. Seventy general practitioners (GPs) were selected to provide either CORFIS (44 GPs) or conventional care (26 GPs) for 6 months. A total of 486 hypertensive patients were recruited; 309 were in the intervention and 177 in the control groups. Primary outcome was the proportion of hypertensive patients who achieved target blood pressure (BP) of <140/90mmHg (for those without diabetes mellitus) and <130/80mmHg (with diabetes mellitus). Secondary outcomes include change in the mean/median BP at 6-month as compared to baseline.
RESULTS: The proportion of hypertensive patients who achieved target BP at 6-month was significantly higher in the CORFIS arm (69.6%) as compared to the control arm (57.6%), P=0.008. Amongst those who had uncontrolled BP at baseline, the proportion who achieved target BP at 6-month was also significantly higher in the CORFIS arm (56.6%) as compared to the control arm (34.1%), p<0.001. There was no difference in the patients who had already achieved BP control at baseline. There were significant reductions in SBP in the CORFIS arm (median -9.0mmHg; -60 to 50) versus control (median -2mmHg; -50 to 48), p=0.003; as well as in DBP (CORFIS arm: median -6.0mmHg; ranged from -53 to 30 versus control arm: median 0.0mmHg; ranged from -42 to 30), p<0.001.
CONCLUSIONS: Patients who received CORFIS care demonstrated significant improvements in achieving target BP.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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