Evidence map›Paper›PMID 31473598›Full record

Trial reportBMJ evidence-based medicine2020

Lack of effects of evidence-based, individualised counselling on medication use in insured patients with mild hypertension in China: a randomised controlled trial.

Mengyang Di, Chen Mao, Zuyao Yang, Hong Ding, Qu Liu, Shuiming Liu, Hongbo Guo, Kunhua Jiang, Jinling Tang

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ evidence-based medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 34% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. The impact of a physician's recommendation and gender on informed decision making: A randomized controlled study in a simulated decision situation.Health expectations : an international journal of public participation in health care and health policy · 2021
    Trial
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 3 countries.

Mengyang DiDepartment of Medicine, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA.
Chen MaoDepartment of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China.
Zuyao YangDivision of Epidemiology, School of Public Health and Primary Care, Chinese University of Hong Kong, New Territories, Hong Kong.ORCID 0000-0003-2386-2431
Hong DingLonggang Center for Disease Control and Prevention, Shenzhen, China.
Qu LiuLonggang Center for Disease Control and Prevention, Shenzhen, China.
Shuiming LiuLonggang Center for Disease Control and Prevention, Shenzhen, China.
Hongbo GuoCentral City Community Healthcare Centre, Longgang People's Hospital, Shenzhen, China.
Kunhua JiangZiwei Garden Community Healthcare Centre, Longgang People's Hospital, Shenzhen, China.
Jinling TangDivision of Epidemiology, School of Public Health and Primary Care, Chinese University of Hong Kong, New Territories, Hong Kong jltang@cuhk.edu.hk.
Chinese University of Hong Kong · HKShenzhen Center for Disease Control and Prevention · CNLonggang Central Hospital · CNSouthern Medical University · CN

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

objectiveTo evaluate whether evidence-based, individualised (EBI) counselling regarding hypertension and the treatment would affect medication use in insured patients with mild hypertension in China.

methodsWe conducted a parallel-group, randomised controlled trial in two primary care centres in Shenzhen, a metropolitan city in China. Patients with mild primary hypertension, 10-year risk of cardiovascular diseases (CVDs) lower than 20% and no history of CVDs were recruited and randomly allocated to two groups. EBI plus general counselling was provided to the intervention group and general counselling alone to the control group. EBI counselling included information on the 10-year CVD risk and treatment benefit in terms of absolute risk reduction estimated for each individual and information on average side effects and costs of antihypertensive drugs. The outcomes included use of antihypertensive drugs and adherence to the treatment at 6-month follow-up, with the former being primary outcome.

resultsTwo hundred and ten patients were recruited, with 103 and 107 allocated to the intervention and control groups, respectively. At baseline, 62.4% of the patients were taking antihypertensive drugs that were all covered by health insurance. At the end of 6-month follow-up, there was no statistically significant difference in the rate of medication use between the intervention group and the control group (65.0% vs 57.9%; OR=1.35, 95% CI: 0.77 to 2.36). The difference in adherence rate between the two groups was not statistically significant either (43.7% vs 40.2%; OR=1.15, 95% CI 0.67 to 2.00]). The results were robust in sensitivity analyses that used different cutoffs to define the two outcomes.

conclusionsThe EBI counselling by health educators other than the caring physicians had little impact on treatment choices and drug-taking behaviours in insured patients with mild primary hypertension in this study. It remains unclear whether EBI counselling would make a difference in uninsured patients, especially when conducted by the caring physicians. TRIAL REGISTRATION NUMBER: ChiCTR-TRC-14004169.

Indexed as

Evidence-Based MedicineMedication AdherenceRisk Reduction BehaviorAntihypertensive AgentsChinaCounselingDrug CostsFemaleHumansHypertensionInsurance CoverageMaleMiddle AgedPrimary Health CareResearch DesignAntihypertensive Agentsantihypertensive treatmentevidence-based medicineindividualised counsellingprimary carerandomised controlled trial

Identifiers

PMID31473598
PMCPMC7286038
OpenAlexW2970262098

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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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.