BACKGROUND:The HOPE 4 trial (Heart Outcomes Prevention and Evaluation 4) investigated the effectiveness of a comprehensive, collaborative model of care, implemented in Colombia and Malaysia, which aimed to reduce cardiovascular disease risk in individuals with hypertension. One component of this intervention was the nomination of a treatment supporter, where participants could select a family member or friend to assist them with their care. The purpose of this study was to investigate the impact of these individuals on participant outcomes, as well as the relationship dynamics between participants and their treatment supporter.METHODS:Participants in the HOPE 4 intervention group with baseline and 12 months of follow-up were included for analysis. They were divided into Every Visit (n=339) and <Every Visit (n=268) groups based on whether they had a treatment supporter for all 5 or for <5 follow-up visits, respectively. Outcomes were stratified between groups and tested for significance using a generalized linear mixed-effects model. A survey investigating participant satisfaction with their treatment supporter was administered at 12 months.RESULTS:Groups were majority female (53% versus 62%) with a mean age of 63 and 66 years. Country of origin differed between groups (22% versus 86%; Colombia). A 15.5% ([95% CI, 6.2%–24.8%] P=0.004) greater increase in statin medication use was reported in the Every Visit group at 12 months compared with the <Every Visit group. Sixty-one percent versus 48.2% of participants reported high medication adherence at 12 months (P<0.003). The difference in change in systolic blood pressure between groups was not found to be significant at 12 months, though it favored the Every Visit group (−2.3 [95% CI, −6.1 to 1.5]; P=0.045). The majority of survey respondents from either study group strongly agreed that having a treatment supporter positively influenced their health.CONCLUSIONS:Long-term support from a nominated treatment supporter was associated with improved adherence, risk factor management, and medication use among individuals with hypertension.REGISTRATION:URL: https://www.clinicaltrials.gov; Unique identifier: NCT01826019.

中文翻译：

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社会支持与临床结果之间的关系：对 HOPE 4 干预中参与者提名的治疗支持者的评估

背景：HOPE 4 试验（心脏结果预防和评估 4）调查了在哥伦比亚和马来西亚实施的综合协作护理模式的有效性，该模式旨在降低高血压患者的心血管疾病风险。该干预措施的一个组成部分是提名一名治疗支持者，参与者可以选择一名家庭成员或朋友来协助他们进行护理。本研究的目的是调查这些个体对参与者结果的影响，以及参与者与其治疗支持者之间的关系动态。 方法：HOPE 4 干预组的参与者包括基线和 12 个月随访的参与者进行分析。根据他们是否在所有 5 次随访或 <5 次随访中是否有治疗支持者，将他们分为每次访视 (n=339) 和 <每次访视 (n=268) 组。结果在组之间进行分层，并使用广义线性混合效应模型测试显着性。在 12 个月时进行了一项调查，调查参与者对其治疗支持者的满意度。结果：各组中大多数为女性（53% 对比 62%），平均年龄为 63 岁和 66 岁。不同群体的原籍国有所不同（22% 与 86%；哥伦比亚）。与<每次就诊组相比，12 个月时每次就诊组的他汀类药物使用量增加了15.5%（[95% CI，6.2%–24.8%] P =0.004）。 61% 和 48.2% 的参与者在 12 个月时报告药物依从性较高（P <0.003）。 12 个月时，各组之间收缩压变化的差异并不显着，尽管“每次就诊”组更有利（−2.3 [95% CI，−6.1 至 1.5]；P = 0.045）。来自任一研究组的大多数调查受访者都强烈同意，拥有治疗支持者会对他们的健康产生积极影响。结论：指定治疗支持者的长期支持与高血压患者依从性、危险因素管理和药物使用的改善相关。注册：网址：https://www.clinicaltrials.gov；唯一标识符：NCT01826019。