Evidence map›Paper›PMID 16595786›Full record

Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2006

Effect of nurse-directed hypertension treatment among First Nations people with existing hypertension and diabetes mellitus: the Diabetes Risk Evaluation and Microalbuminuria (DREAM 3) randomized controlled trial.

Sheldon W Tobe, George Pylypchuk, Joan Wentworth, Alexander Kiss, John Paul Szalai, Nancy Perkins, Susan Hartman, Laurie Ironstand, Jacqueline Hoppe

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

Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 14 pooled it
4.2field-weighted citation impact, top 5% 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

38 citing papers in PubMed, 14 syntheses or guidelines pooled it, 93 citations in OpenAlex.

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  9. Self-monitoring and other non-pharmacological interventions to improve the management of hypertension in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010
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  11. Quality-improvement strategies for the management of hypertension in chronic kidney disease in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010
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  18. Assessment of the Siksika chronic disease nephropathy-prevention clinic.Canadian family physician Medecin de famille canadien · 2013
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Sheldon W TobeDivision of Nephrology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ont. sheldon.tobe@sw.ca
George Pylypchuk
Joan Wentworth
Alexander Kiss
John Paul Szalai
Nancy Perkins
Susan Hartman
Laurie Ironstand
Jacqueline Hoppe
Health Sciences Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFirst Nations people with diabetes mellitus and hypertension are at greater risk of renal and cardiovascular complications than are non-native patients because of barriers to health care services. We conducted this randomized controlled trial to assess whether a community-based treatment strategy implemented by home care nurses would be effective in controlling hypertension in First Nations people with existing hypertension and type 2 diabetes.

methodsWe compared 2 community-based strategies for controlling hypertension in First Nations people with existing hypertension and diabetes. In the intervention group, a home care nurse followed a predefined treatment algorithm of pharmacologic antihypertensive therapy. In the control group, treatment decisions were made by each subject's primary care physician. The primary outcome measure was the difference between the 2 groups in the change in systolic blood pressure after 12 months. Secondary outcome measures were the change in diastolic blood pressure over time, the change in urine albumin status and the incidence of adverse events.

resultsBoth groups experienced a significant reduction in systolic blood pressure by the final visit (by 24.0 [standard deviation (SD) 13.5] mm Hg in the intervention group and by 17.0 [SD 18.6] mm Hg in the control group); p < 0.001 in each case). However, the difference between the 2 groups in this change was not significant. Patients in the intervention group had a larger decrease in diastolic blood pressure over time than did those in the control group (by 11.6 [SD 10.6] mm Hg v. 6.8 [SD 11.1] mm Hg respectively; p = 0.05). The groups did not differ significantly in terms of changes in urine albumin excretion or incidence of adverse events.

interpretationHigh rates of blood pressure control in the community were achieved in both groups in the DREAM 3 study. The addition of a home care nurse to implement a treatment strategy for blood pressure control was more effective in lowering diastolic than systolic blood pressure compared with home care visits for blood pressure monitoring alone and follow-up treatment by a family physician.

Indexed as

Home Care ServicesIndians, North AmericanInuitRural Health ServicesAdultAgedAlgorithmsAntihypertensive AgentsCanadaDiabetes ComplicationsDiabetes Mellitus, Type 2FemaleHumansHypertensionMaleMiddle AgedAntihypertensive Agents

Identifiers

PMID16595786
PMCPMC1435956
OpenAlexW2089477177

What Socratic holds

Textmetadata
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 Socratic graph.