Blood pressure control in low-income minority patients can be improved by teaching patients to monitor their blood pressure at home and having nonprofessional health coaches assist patients by counseling them on medication adherence. Monitoring the change in systolic blood pressure over 6 months in 237 patients randomized to receive in-home health coaching with or without in-home adjustment of their antihypertensive medications, researchers found both arms had significant reductions in systolic blood pressure (mean 22 mm Hg decrease), as well as a decrease in the number of primary care visits from 3.5 in the 6 months before the study to 2.6 in the 6-month study period and 2.4 in the 6 months after the study. The more coaching encounters patients had, the greater their reduction in blood pressure. As less than one-fifth of patients in the home titration arm actually undertook an adjustment of their antihypertensive medication at home, the feasibility of home titration still remains uncertain. The authors conclude that because blood pressure control was improved using minimally trained nonprofessional staff, this intervention holds promise for improving hypertension control without increasing demand on physician time.
Health Coaching to Improve Hypertension Treatment in a Low-Income, Minority Population
By Thomas Bodenheimer, MD, et al
University of California, San Francisco
Family Physician Reflects on Why He Loves His Work
In an essay, a family physician in El Salvador reflects on the personal joys family medicine has brought him, touching on six themes that continue to rejuvenate his practice: love, faith, mystery, place, dance and medicine. By examining the emotional and psychological dimensions of these themes, he offers a path by which other family physicians may be able to find sustenance and joy in their daily work.
The Joy of Family Practice
By William Ventres, MD, MA
University of E
|Contact: Angela Sharma|
American Academy of Family Physicians