Home > Review Articles > Defend: a community-based model of care to improve blood pressure control in Mäori and Pacific patients with diabetic nephropathy

Defend: a community-based model of care to improve blood pressure control in Mäori and Pacific patients with diabetic nephropathy

Making Education Easy

From Māori Health Review Issue 6
Authors:
  • Collins JF et al
Summary:

This randomised controlled trial investigated blood pressure control in Mäori and Pacific patients with type 2 diabetes mellitus and diabetic nephropathy. Participants (n = 65) were randomised to usual clinic care (UC) or community care (CC) where they received monthly visits by nurse-led Mäori or Pacific Island Health Care Assistants (HCA). During community visits the HCA adjusted antihypertensive medication according to protocol, toward a target blood pressure of < 130/80. Reassessment occurred at 12 months at closure (14-23 months). Overall, community care was more effective than usual care.

Comment:
Dr Cherie Hotu, one of the first Mäori endocrinologists specialising in diabetes was a principal investigator in this study that aimed to improve outcomes for Mäori with Type 2 DM complicated by renal disease. Optimal BP is an important step in preventing further deterioration in renal function and preventing cardiovascular disease including heart attacks and stroke. Participants were recruited for this study from the Auckland region and as you can see, community care was more effective than usual care. Hopefully the evidence leads to a change in practice.
Abstract
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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