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E B Schron

Publications and source records attributed to E B Schron.

22 records · Page 2Linked to original sources
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The systolic hypertension in the elderly program. Implications for nursing practice and research.

The Systolic Hypertension in the Elderly Program (SHEP) encompasses two clinical trials--a pilot study and a full-scale trial--investigating the safety and efficacy of antihypertensive therapy for patients aged 60 years and over with isolated systolic hypertension (ISH), that is, systolic blood pressure (SBP) greater than or equal to 160 mmHg and diastolic blood pressure (DBP) less than 90 mmHg. An optimal result of the full-scale trial should lead to recommendations for prescription of effective therapy that preserves the quality of life while reducing the long-term risks of stroke, other cardiovascular disease, and death. This article briefly describes the design, protocol, and organization for the pilot and fullscale SHEP studies. In these trials the nurses help plan study protocol, coordinate patient recruitment, provide patient care, and maintain protocol compliance. In order to accomplish their role in data collection and reporting, they undergo comprehensive training and certification. Nurses utilize the multicenter clinical trial as an opportunity to participate in research, both independently and collaboratively. The specific roles of nurses within these trials, as well as features of these trials that relate to nursing practice and research, are discussed.

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Relation of sociodemographic, clinical, and quality-of-life variables to adherence in the cardiac arrhythmia suppression trial.

Clearly, age and education are important factors for predicting adherence in CAST, given that they appear in all three regressions. Moreover, the 4-month and 1-year results indicate that mental health and presence of a spouse are important predictors. Physical function, stress, angina, and history of MI may also provide additional information regarding adherence levels. It is interesting to note that although adherence was higher for patients who have "good" social characteristics, such as having a spouse, support, integration, perceived good health, good mental health, low stress, and education, it was also better for those patients who had "poor" physical characteristics such as a history of angina, a history of MI, and low physical function. In the multivariate analysis, older age was also associated with good adherence. These observations are not necessarily intuitive and support the need for further research in this area. If patients at risk for poor adherence can be identified prospectively, strategies may be developed to improve their subsequent medical care in such a way to favorably affect and improve their outcomes.

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