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So R, Kariyama K, Oyamada S, Matsushita S, Nishimura H, Tezuka Y, Sunami T, Furukawa TA, Kawaguchi M, Kobashi H, Nishina S, Otsuka Y, Tsujimoto Y, Horie Y, Yoshiji H, Yuzuriha T, Nouso K. Prevalence of hazardous drinking and suspected alcohol dependence in Japanese primary care settings. Gen Hosp Psychiatry 2024; 89:8-15. [PMID: 38657355 DOI: 10.1016/j.genhosppsych.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE We aimed to assess the prevalence of hazardous drinking and potential alcohol dependence among Japanese primary care patients, and their readiness to change and awareness of others' concerns. METHODS From July to August 2023, we conducted a multi-site cross-sectional study as a screening survey for participants in a cluster randomized controlled trial. The trial included outpatients aged 20-74 from primary care clinics. Using the Alcohol Use Disorders Identification Test (AUDIT) alongside a self-administered questionnaire, we evaluated the prevalence of hazardous drinking and suspected alcohol dependence, patients' readiness to change, and their awareness of others' concerns. RESULTS Among the 1388 participants from 18 clinics, 22% (95% confidence interval (CI): 20% to 24%) were identified as engaging in hazardous drinking or suspected of being alcohol dependent. As the AUDIT scores increased, so did their readiness to change. However, only 22% (95%CI: 16% to 28%) of those with scores ranging from 8 to 14 reported that others, including physicians, had expressed concerns about their drinking during the past year. For those with scores of 15 or higher, the figure was 74%. CONCLUSIONS This study underscores the need for universal or high-risk alcohol screening and brief intervention in Japanese primary care settings. Trial registry UMIN-CTR (https://www.umin.ac.jp/ctr/) (UMIN000051388).
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Affiliation(s)
- Ryuhei So
- Okayama Psychiatric Medical Center, Okayama, Japan; CureApp, Inc., Tokyo, Japan; Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan; Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan.
| | - Kazuya Kariyama
- Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
| | | | - Sachio Matsushita
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Hiroki Nishimura
- Okayama Psychiatric Medical Center, Okayama, Japan; CureApp, Inc., Tokyo, Japan
| | - Yukio Tezuka
- Department of Psychiatry, Okinawa Rehabilitation Center Hospital, Okinawa, Japan
| | | | - Toshi A Furukawa
- Office of Institutional Advancement and Communications, Kyoto University, Kyoto, Japan; Kyoto University, Graduate School of Medicine / School of Public Health, Kyoto, Japan
| | | | - Haruhiko Kobashi
- Department of Hepatology, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Sohji Nishina
- Department of Gastroenterology and Hepatology, Kawasaki Medical School, Okayama, Japan
| | - Yuki Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasushi Tsujimoto
- Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan; Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan; Oku Medical Clinic, Osaka, Japan
| | | | - Hitoshi Yoshiji
- Department of Gastroenterology, Nara Medical University, Nara, Japan
| | - Takefumi Yuzuriha
- National Hospital Organization Hizen Psychiatric Medical Center, Saga, Japan; Chikugo Yoshii Cocoro Hospital, Fukuoka, Japan
| | - Kazuhiro Nouso
- Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
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Ito M, Tajika A, Toyomoto R, Imai H, Sakata M, Honda Y, Kishimoto S, Fukuda M, Horinouchi N, Sahker E, Furukawa TA. The short and long-term efficacy of nurse-led interventions for improving blood pressure control in people with hypertension in primary care settings: a systematic review and meta-analysis. BMC PRIMARY CARE 2024; 25:143. [PMID: 38678180 PMCID: PMC11056068 DOI: 10.1186/s12875-024-02380-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/09/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Previous systematic reviews suggest that nurse-led interventions improve short-term blood pressure (BP) control for people with hypertension. However, the long-term effects, adverse events, and appropriate target BP level are unclear. This study aimed to evaluate the long-term efficacy and safety of nurse-led interventions. METHODS We conducted a systematic review and meta-analysis. We searched the Cochrane Central Register of Controlled Trials, PubMed, and CINAHL, as well as three Japanese article databases, as relevant randomized controlled trials from the oldest possible to March 2021. This search was conducted on 17 April 2021. We did an update search on 17 October 2023. We included studies on adults aged 18 years or older with hypertension. The treatments of interest were community-based nurse-led BP control interventions in addition to primary physician-provided care as usual. The comparator was usual care only. Primary outcomes were long-term achievement of BP control goals and serious adverse events (range: 27 weeks to 3 years). Secondary outcomes were short-term achievement of BP control goals and serious adverse events (range: 4 to 26 weeks), change of systolic and diastolic BP from baseline, medication adherence, incidence of hypertensive complications, and total mortality. RESULTS We included 35 studies. Nurse-led interventions improved long-term BP control (RR 1.10, 95%CI 1.03 to 1.18). However, no significant differences were found in the short-term effects of nurse-led intervention compared to usual care about BP targets. Little information on serious adverse events was available. There was no difference in mortality at both terms between the two groups. Establishing the appropriate target BP from the extant trials was impossible. CONCLUSIONS Nurse-led interventions may be more effective than usual care for achieving BP control at long-term follow-up. It is important to continue lifestyle modification for people with hypertension. We must pay attention to adverse events, and more studies examining appropriate BP targets are needed. Nurse-led care represents an important complement to primary physician-led usual care.
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Affiliation(s)
- Masami Ito
- Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto, 606-8501, Japan
| | - Aran Tajika
- Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto, 606-8501, Japan
| | - Rie Toyomoto
- Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto, 606-8501, Japan
| | - Hissei Imai
- Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto, 606-8501, Japan
| | - Masatsugu Sakata
- Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto, 606-8501, Japan
| | - Yukiko Honda
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Social Medicine, National Centre for Child Health and Development, Tokyo, Japan
| | - Sanae Kishimoto
- Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto, 606-8501, Japan
| | - Memori Fukuda
- Department of Health Informatics, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
| | - Noboru Horinouchi
- Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto, 606-8501, Japan
- Department of General Medicine, Oita University Faculty of Medicine, Oita, Japan
| | - Ethan Sahker
- Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto, 606-8501, Japan
- Population Health and Policy Research Unit, Medical Education Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshi A Furukawa
- Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto, 606-8501, Japan.
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Ye XF, Wang WYY, Wang XY, Huang QF, Li Y, Wang JG. Alcohol Consumption and Antihypertensive Treatment Effect in Male Patients With Hypertension. Am J Hypertens 2024; 37:112-119. [PMID: 37769181 DOI: 10.1093/ajh/hpad091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 07/03/2023] [Accepted: 09/25/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Alcohol consumption is a proven risk factor of hypertension. In the present analysis, we investigated the use of antihypertensive medications and blood pressure control in male alcohol drinkers and non-drinkers with hypertension (systolic/diastolic blood pressure 160-199/100-119 mm Hg). METHODS The study participants were patients enrolled in a 12-week therapeutic study and treated with the irbesartan/hydrochlorothiazide combination 150/12.5 mg once daily, with the possible up-titration to 300/12.5 mg/day and 300/25 mg/day at 4 and 8 weeks of follow-up, respectively, for blood pressure control of <140/90 mm Hg or <130/80 mm Hg in patients with diabetes mellitus. Alcohol consumption was classified as non-drinkers and drinkers. RESULTS The 68 alcohol drinkers and 168 non-drinkers had similar systolic/diastolic blood pressure at baseline (160.8 ± 12.1/99.8 ± 8.6 vs. 161.8 ± 11.0/99.2 ± 8.6, P ≥ 0.55) and other characteristics except for current smoking (80.9% vs. 47.6%, P < 0.0001). In patients who completed the 12-week follow-up (n = 215), the use of higher dosages of antihypertensive drugs was similar at 4 weeks of follow-up in drinkers and non-drinkers (10.6% vs. 12.4%, P = 0.70), but increased to a significantly higher proportion in drinkers than non-drinkers at 12 weeks of follow-up (54.7% vs. 36.6%, P = 0.01). The control rate of hypertension tended to be lower in alcohol drinkers, compared with non-drinkers, at 4 weeks of follow-up (45.6% vs. 58.9%, P = 0.06), but became similar at 12 weeks of follow-up (51.5% vs. 54.8%, P = 0.65). CONCLUSION Alcohol drinkers compared with non-drinkers required a higher dosage of antihypertensive drug treatment to achieve similar blood pressure control. CLINICAL TRIAL REGISTRY NUMBER NCT00670566 at www.clinicaltrials.gov.
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Affiliation(s)
- Xiao-Fei Ye
- Department of Epidemiology and Statistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen-Yuan-Yue Wang
- Department of Epidemiology and Statistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin-Yu Wang
- Department of Epidemiology and Statistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi-Fang Huang
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Li
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ji-Guang Wang
- Department of Epidemiology and Statistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Bulto LN, Roseleur J, Noonan S, Pinero de Plaza MA, Champion S, Dafny HA, Pearson V, Nesbitt K, Gebremichael LG, Beleigoli A, Gulyani A, Schultz T, Hines S, Clark RA, Hendriks JM. Effectiveness of nurse-led interventions versus usual care to manage hypertension and lifestyle behaviour: a systematic review and meta-analysis. Eur J Cardiovasc Nurs 2024; 23:21-32. [PMID: 37130339 DOI: 10.1093/eurjcn/zvad040] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/04/2023]
Abstract
AIMS This review aimed to investigate the effectiveness of nurse-led interventions vs. usual care on hypertension management, lifestyle behaviour, and patients' knowledge of hypertension and associated risk factors. METHODS A systematic review with meta-analysis was conducted following Joanna Briggs Institute (JBI) guidelines. MEDLINE (Ovid), EmCare (Ovid), CINAHL (EBSCO), Cochrane library, and ProQuest (Ovid) were searched from inception to 15 February 2022. Randomized controlled trials (RCTs) examining the effect of nurse-led interventions on hypertension management were identified. Title and abstract, full text screening, assessment of methodological quality, and data extraction were conducted by two independent reviewers using JBI tools. A statistical meta-analysis was conducted using STATA version 17.0. RESULTS A total of 37 RCTs and 9731 participants were included. The overall pooled data demonstrated that nurse-led interventions may reduce systolic blood pressure (mean difference -4.66; 95% CI -6.69, -2.64; I2 = 83.32; 31 RCTs; low certainty evidence) and diastolic blood pressure (mean difference -1.91; 95% CI -3.06, -0.76; I2 = 79.35; 29 RCTs; low certainty evidence) compared with usual care. The duration of interventions contributed to the magnitude of blood pressure reduction. Nurse-led interventions had a positive impact on lifestyle behaviour and effectively modified diet and physical activity, but the effect on smoking and alcohol consumption was inconsistent. CONCLUSION This review revealed the beneficial effects of nurse-led interventions in hypertension management compared with usual care. Integration of nurse-led interventions in routine hypertension treatment and prevention services could play an important role in alleviating the rising global burden of hypertension. REGISTRATION PROSPERO: CRD42021274900.
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Affiliation(s)
- Lemma N Bulto
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Jacqueline Roseleur
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Sara Noonan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Maria Alejandra Pinero de Plaza
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
- National Health and Medical Research Council, Transdisciplinary Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide, 5005, SA, Australia
| | - Stephanie Champion
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Hila Ariela Dafny
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Vincent Pearson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Katie Nesbitt
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Lemlem G Gebremichael
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Alline Beleigoli
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Aarti Gulyani
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Timothy Schultz
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- National Health and Medical Research Council, Transdisciplinary Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide, 5005, SA, Australia
| | - Sonia Hines
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
- Flinders Rural and Remote Health, NT. College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Robyn A Clark
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Jeroen M Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, 5001, SA, Australia
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