Introduction:Inadequate blood pressure(BP)control is a significant challenge.Therapeutic decisions based on home blood pressure monitoring(HBPM)have been shown to lead to better blood pressure control compared to thos...Introduction:Inadequate blood pressure(BP)control is a significant challenge.Therapeutic decisions based on home blood pressure monitoring(HBPM)have been shown to lead to better blood pressure control compared to those based on office blood pressure(OBP)measurements alone.Objectives:To compare,over a five-year period,the annual BP control rates in hypertensive patients who were treated and monitored by the same cardiologists and who periodically used HBPM.Methodology:This was a multicenter study conducted with five cross-sectional analyses at annual intervals,with the first in 2019 and the last in 2023.OBP and HBPM measurements were performed according to current guidelines.Two cutoff points were considered for the analysis of BP control by OBP:<140/90 mmHg and<130/80 mmHg.For HBPM,the cutoff was<130/80 mmHg.Comparisons of quantitative variables between years were established using the t-test or chi-square test.A p-value<0.05 was considered significant.Results:A total of 8,890 individuals with a mean age of 63.3(±14.9)years were included,of whom 65.8%were women.A reduction in mean OBP values was observed between 2019-2020 and 2021-2022.There was also a reduction in the average number of antihypertensive medications used in 2020,with a mean of 1.99 medications taken that year.Compared to 2020,2022 showed an improvement in control rates for OBP<130/80 mmHg(31.5%vs.35.7%;p=0.008)and OBP<140/90 mmHg(58.7%vs.65.7%;p<0.001).Conclusion:Continuous monitoring by the same physician and the use of home measurement tools can lead to better BP control in hypertensive patients.展开更多
Stomach pain in Chinese medicine（CM） is a very common disorder in clinical practice and it has been listed as one of the pilot three conditions in Hong Kong to develop evidence-based CM clinical practice guidelines...Stomach pain in Chinese medicine（CM） is a very common disorder in clinical practice and it has been listed as one of the pilot three conditions in Hong Kong to develop evidence-based CM clinical practice guidelines（CM CPGs）. The aim of this stomach Pain CPG is to summarize the treatment methods of stomach pain with CM and evaluate reasonably, then to guide local licensed CM practitioners and provide beneficial reference for social medical decision makers and patients. In this manuscript, we defined stomach pain in CM and the category of chronic gastritis in Western medicine. The clinical manifestation, CM pattern classification, and CM intervention including herbal medicine treatment based on pattern differentiation, symptomatic treatment, acupuncture treatment, regulation and nursing were illustrated.展开更多
Objective:Determine uptake of prostate-specific antigen(PSA)testing in Medicare benefi-ciaries according to previous receipt of PSA testing.Methods:A 5%random sample of men aged 67 years or older without a previous di...Objective:Determine uptake of prostate-specific antigen(PSA)testing in Medicare benefi-ciaries according to previous receipt of PSA testing.Methods:A 5%random sample of men aged 67 years or older without a previous diagnosis of prostate cancer was identified through 2009-2012 Medicare claims.We measured the annualized frequency of PSA screening among men due for PSA testing,stratified by PSA testing use in the previous 2 years,and clustered by ordering provider.Results:Throughout the study period,PSA testing use was consistently higher for men with previous screening than for men without previous screening.For men without previous screening,there was a decline in testing that was most pronounced in 2012.Compared with 2009,the cor-responding odds ratios were 0.98[95%confidence interval(CI)(0.96-1.00)]in 2010,0.94[95%CI(0.92-0.95)]in 2011,and 0.66[95%CI(0.65-0.68)]in 2012.In contrast,for men with previous screening,PSA testing frequency was stable from 2009 to 2011,and declined to a lesser extent in 2012[odds ratio 0.80,95%CI(0.79-0.81)].Conclusion:Receipt of PSA testing is highly dependent on whether an individual was tested in the recent past.In previously unscreened men,the largest decrease occurred in 2012,which may reflect in part the publication of US Preventive Services Task Force guidelines,but there was much less impact among men already being screened.展开更多
文摘Introduction:Inadequate blood pressure(BP)control is a significant challenge.Therapeutic decisions based on home blood pressure monitoring(HBPM)have been shown to lead to better blood pressure control compared to those based on office blood pressure(OBP)measurements alone.Objectives:To compare,over a five-year period,the annual BP control rates in hypertensive patients who were treated and monitored by the same cardiologists and who periodically used HBPM.Methodology:This was a multicenter study conducted with five cross-sectional analyses at annual intervals,with the first in 2019 and the last in 2023.OBP and HBPM measurements were performed according to current guidelines.Two cutoff points were considered for the analysis of BP control by OBP:<140/90 mmHg and<130/80 mmHg.For HBPM,the cutoff was<130/80 mmHg.Comparisons of quantitative variables between years were established using the t-test or chi-square test.A p-value<0.05 was considered significant.Results:A total of 8,890 individuals with a mean age of 63.3(±14.9)years were included,of whom 65.8%were women.A reduction in mean OBP values was observed between 2019-2020 and 2021-2022.There was also a reduction in the average number of antihypertensive medications used in 2020,with a mean of 1.99 medications taken that year.Compared to 2020,2022 showed an improvement in control rates for OBP<130/80 mmHg(31.5%vs.35.7%;p=0.008)and OBP<140/90 mmHg(58.7%vs.65.7%;p<0.001).Conclusion:Continuous monitoring by the same physician and the use of home measurement tools can lead to better BP control in hypertensive patients.
基金Supported by Hong Kong Hospital Authority Research Project,the Development of Chinese Clinical Practice Guidelines in Hong Kong,China(No.HA820/126/19/19/14/6/12/1)
文摘Stomach pain in Chinese medicine（CM） is a very common disorder in clinical practice and it has been listed as one of the pilot three conditions in Hong Kong to develop evidence-based CM clinical practice guidelines（CM CPGs）. The aim of this stomach Pain CPG is to summarize the treatment methods of stomach pain with CM and evaluate reasonably, then to guide local licensed CM practitioners and provide beneficial reference for social medical decision makers and patients. In this manuscript, we defined stomach pain in CM and the category of chronic gastritis in Western medicine. The clinical manifestation, CM pattern classification, and CM intervention including herbal medicine treatment based on pattern differentiation, symptomatic treatment, acupuncture treatment, regulation and nursing were illustrated.
基金This research was supported by a Research Scholar Grant(RSGI-12-218-01-CPHPS)from the American Cancer Society(to G.S.C.),the Case Comprehensive Cancer Center(P30-CA43703-18)the Case Clinical and Translational Science Collaborative(UL1 TR000439).
文摘Objective:Determine uptake of prostate-specific antigen(PSA)testing in Medicare benefi-ciaries according to previous receipt of PSA testing.Methods:A 5%random sample of men aged 67 years or older without a previous diagnosis of prostate cancer was identified through 2009-2012 Medicare claims.We measured the annualized frequency of PSA screening among men due for PSA testing,stratified by PSA testing use in the previous 2 years,and clustered by ordering provider.Results:Throughout the study period,PSA testing use was consistently higher for men with previous screening than for men without previous screening.For men without previous screening,there was a decline in testing that was most pronounced in 2012.Compared with 2009,the cor-responding odds ratios were 0.98[95%confidence interval(CI)(0.96-1.00)]in 2010,0.94[95%CI(0.92-0.95)]in 2011,and 0.66[95%CI(0.65-0.68)]in 2012.In contrast,for men with previous screening,PSA testing frequency was stable from 2009 to 2011,and declined to a lesser extent in 2012[odds ratio 0.80,95%CI(0.79-0.81)].Conclusion:Receipt of PSA testing is highly dependent on whether an individual was tested in the recent past.In previously unscreened men,the largest decrease occurred in 2012,which may reflect in part the publication of US Preventive Services Task Force guidelines,but there was much less impact among men already being screened.
