Evidence map›Paper›PMID 30592662›Full record

Trial reportCirculation2019

Sustainability of Blood Pressure Reduction in Black Barbershops.

Ronald G Victor, Ciantel A Blyler, Ning Li, Kathleen Lynch, Norma B Moy, Mohamad Rashid, L Cindy Chang, Joel Handler, Jeffrey Brettler, Florian Rader and 1 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 5 pooled it
9.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 5 syntheses or guidelines pooled it, 121 citations in OpenAlex.

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7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Ronald G VictorSmidt Heart Institute at Cedars-Sinai Medical Center, Los Angeles, CA (R.G.V., C.A.B., K.L., N.B.M., M.R., F.R.).
Ciantel A BlylerSmidt Heart Institute at Cedars-Sinai Medical Center, Los Angeles, CA (R.G.V., C.A.B., K.L., N.B.M., M.R., F.R.).
Ning LiDepartment of Biomathematics at University of California, Los Angeles, David Geffen School of Medicine (N.L., L.C.C., R.M.E.).
Kathleen LynchSmidt Heart Institute at Cedars-Sinai Medical Center, Los Angeles, CA (R.G.V., C.A.B., K.L., N.B.M., M.R., F.R.).
Norma B MoySmidt Heart Institute at Cedars-Sinai Medical Center, Los Angeles, CA (R.G.V., C.A.B., K.L., N.B.M., M.R., F.R.).
Mohamad RashidSmidt Heart Institute at Cedars-Sinai Medical Center, Los Angeles, CA (R.G.V., C.A.B., K.L., N.B.M., M.R., F.R.).
L Cindy ChangDepartment of Biomathematics at University of California, Los Angeles, David Geffen School of Medicine (N.L., L.C.C., R.M.E.).
Joel HandlerKaiser-Permanente, Los Angeles, CA (J.H., J.B.).
Jeffrey BrettlerKaiser-Permanente, Los Angeles, CA (J.H., J.B.).
Florian RaderSmidt Heart Institute at Cedars-Sinai Medical Center, Los Angeles, CA (R.G.V., C.A.B., K.L., N.B.M., M.R., F.R.).
Robert M ElashoffDepartment of Biomathematics at University of California, Los Angeles, David Geffen School of Medicine (N.L., L.C.C., R.M.E.).
Cedars-Sinai Smidt Heart Institute · USUniversity of California, Los Angeles · USKaiser Permanente · US

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
Barber-Pharmacist Coordination to Improve Blood Pressure Management in Black MenR01HL117983 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI ALBERT, CHRISTINE M · 2014 to 2018
$8.6M
NCATS NIH HHS UL1 TR001881NHLBI NIH HHS R01 HL117983
6 · The paper itself

Abstract

backgroundWe developed a new model of hypertension care for non-Hispanic black men that links health promotion by barbers to medication management by American Society of Hypertension-certified pharmacists and demonstrated efficacy in a 6-month cluster-randomized trial. The marked reduction in systolic blood pressure (BP) seen at 6 months warranted continuing the trial through 12 months to test sustainability, a necessary precondition for implementation research.

methodsWe enrolled a cohort of 319 black male patrons with systolic BP ≥140 mm Hg at baseline. Fifty-two Los Angeles County barbershops were assigned to either a pharmacist-led intervention or an active control group. In the intervention group, barbers promoted follow-up with pharmacists who prescribed BP medication under a collaborative practice agreement with patrons' primary care providers. In the control group, barbers promoted follow-up with primary care providers and lifestyle modification. After BP assessment at 6 months, the intervention continued with fewer in-person pharmacist visits to test whether the intervention effect could be sustained safely for 1 year while reducing pharmacist travel time. Final BP and safety outcomes were assessed in both groups at 12 months.

resultsAt baseline, mean systolic BP was 152.4 mm Hg in the intervention group and 154.6 mm Hg in the control group. At 12 months, mean systolic BP fell by 28.6 mm Hg (to 123.8 mm Hg) in the intervention group and by 7.2 mm Hg (to 147.4 mm Hg) in the control group. The mean reduction was 20.8 mm Hg greater in the intervention (95% CI, 13.9-27.7; P<0.0001). A BP <130/80 mm Hg was achieved by 68.0% of the intervention group versus 11.0% of the control group ( P<0.02). These new 12-month efficacy data are statistically indistinguishable from our previously reported 6-month data. No treatment-related serious adverse events occurred in either group over 12 months. Cohort retention at 12 months was 90% in both groups.

conclusionsAmong black male barbershop patrons with uncontrolled hypertension, health promotion by barbers resulted in large and sustained BP reduction over 12 months when coupled with medication management by American Society of Hypertension-certified pharmacists. Broad-scale implementation research is both justified and warranted. CLINICAL

trial registrationURL: https://www.clinicaltrials.gov . Unique identifier: NCT 02321618.

Indexed as

BarberingBlack or African AmericanAdultAgedAntihypertensive AgentsBlood PressureCommunity Pharmacy ServicesCultural CharacteristicsHealth Knowledge, Attitudes, PracticeHealth PromotionHumansHypertensionLos AngelesMaleMiddle AgedPatient Acceptance of Health CareAntihypertensive Agentscontinental population groupsethnic groupshypertension

Identifiers

PMID30592662
PMCPMC6917481
OpenAlexW2905099883

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.