The following is a summary of “Research on the control rate of hypertension under family physician-contracted service,” published in the January 2024 issue of Primary Care by Zheng, et al.
Hypertension stands as a significant global public health concern, prompting the widespread use of Family Physician-Contracted Service (FPCS) in hypertension management. For a study, researchers sought to evaluate the impact of FPCS on hypertension control.
A comprehensive search across PubMed, Web of Science, the Cochrane Library, China National Knowledge Network, Chinese Scientific and Technological Journal Database (CQVIP), and Wanfang Database was conducted to identify randomized controlled trials assessing the effect of FPCS on hypertension control. Meta-analysis was performed on eligible literature, with meta-regression employed to identify sources of heterogeneity. Subgroup analysis was further conducted, and risk difference (RD) with a 95% CI served as an effect measure. Publication bias and sensitivity analyses were also conducted.
The meta-analysis comprised 46 studies, revealing a pooled RD indicating a significant improvement in hypertension control by 19% (RD = 0.19; 95%CI: 0.16–0.21; P < 0.001; I2 = 59.3%) with FPCS. Meta-regression identified average age (β = 0.28; P = 0.05) and intervention mode (β = 0.36; P < 0.001) as sources of heterogeneity. Subgroup analysis demonstrated higher hypertension control rates among the elderly compared to the working-age population (93.6% vs. 90.1%). Furthermore, the “family physician” mode (FP), “family physician + patient” mode (FPP), and “family physician + patient + family member” mode (FPPF) exhibited control rates of 90.1%, 94.4%, and 92.6%, respectively. Sensitivity analysis confirmed robust results with no discernible publication bias.
FPCS significantly contributed to hypertension control, with control efficacy influenced by average age and intervention mode. Notably, hypertension control appeared more effective among the elderly, and modes involving patient and family member engagement show greater efficacy. Moving forward, emphasis should be placed on enhancing the quality and continuity of FPCS while promoting patient self-management and family support to optimize hypertension management.
Reference: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02280-0