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Biomedical subjects

M H Alderman

Publications and source records attributed to M H Alderman.

At least 163 records · Page 9Linked to original sources
PubMed1980

Cost of hypertension control at the workplace.

A cost analysis of hypertension treatment at the workplace indicates that average patient cost in 1978 was $194.77. The distribution of cost is: clinical personnel, 26.7%; administrative personnel, 26.7%; drugs, 23.9%; laboratory, 3.4%; clinical supplies, 1.1%; general supplies and other operating expenses, 8.7%; equipment use, 1.0%; and rent, 2.6%. This aggregate cost is well below that reported for care provided in private practice and hospital outpatient department settings. The study further indicates that the constant dollar cost of care declines over the first three of four years and begins to stabilize at the fourth year. During the initial three-year period drug costs rise, but fewer revisits are required to attain and maintain blood pressure control. Drug utilization and the number of revisits per year stabilize at the fourth year.

Costs and Cost Analysis↗
PubMed1980

Blood pressure control programs on and off the worksite.

In order to assess the importance of physical accessibility in the efficacy of a union-sponsored, worksite-based hypertension detection and treatment program, the experience of patients offered identical systematic treatment in worksite and non-worksite settings was compared. Although attrition was greater in the offsite clinic in the first year, the difference disappeared by the second year. Successful blood pressure control was maintained over three years in both treatment sites. These results suggest that physical accessibility was not the sole or even the most important factor producing favorable results in this program. Other factors such as protocol-directed treatment by non-physicians, the categorical nature of the program, lack of cost, and a socially cohesive work community may singly or together be factors responsible for successful therapy.

Blood Pressure↗
PubMed1979

Systolic hypertension: occurrence and treatment in a defined community.

Systolic hypertension, a disorder occurring predominantly in the elderly, is associated with an increased incidence of stroke and coronary artery disease. Based on the supposition that it is a risk factor, many authorities have urged that it be treated. This report concerns an experience in treating systolic hypertension in a defined ambulatory population of 898 hypertensive subjects in a work-site program. The systolic hypertension group (N = 39) was compared with a matched diastolic hypertension group and with a matched systolic/diastolic hypertension group (N = 39 each). The patients with systolic hypertension responded to standard treatment (chiefly with diuretics), but less satisfactorily than did the patients with diastolic hypertension. Side effects or toxicity were uncommon and did not interfere with the therapeutic regimen. However, the ultimate value of such therapy in the prevention of vascular complications remains to be determined.

Diastole↗
PubMed1979

Blood pressure control in private practice: a case report.

High blood pressure is most commonly treated in the offices of private physicians. We have attempted to evaluate the efficacy of such care through review of all patient charts of a Board Certified, University Medical Center affiliated internist in New York City. Seventeen per cent had elevated (greater than or equal to 160/95) blood pressures or were taking antihypertensive medication at the time of their last visit. A selected group of 206 charts was examined to determine attendance and blood pressure outcome. Over one-half of these patients were lost to follow-up within a year of their initial visit. Of those who persisted in therapy, 55 per cent achieved good blood pressure control. Blood pressure outcomes among medicated patients were not different from those of patients who received no prescription. These results suggest that this conventional pattern of ambulatory medical care, characterized by a high attrition rate and a failure to adequately control blood pressure, may not be suitable to the long-term management of high blood pressure.

Female↗
PubMed1978

Blood pressure control: the effect of facilitated access to treatment.

1. Effectiveness of hypertension care has been compared in patients treated at a Union health centre and at their place of work. 2. Patient adherence and blood pressure control is not affected by the place of treatment. 3. A systematic approach to treatment can be successful in a large population group.

Follow-Up Studies↗
PubMed1977

Treatment of hypertension at the university medical clinic.

The treatment of high blood pressure at the general medical clinic of a traditionally oriented university hospital was found to be unsatisfactory for most patients. Charts of all hypertensive patients (diastolic blood pressure, greater than or equal to 105 mm Hg) who made their first clinic visit in 1964 or 1971 were reviewed. Half of all patients were lost to follow-up within the first year, and blood pressure control was achieved by only one third of the patients. New information contained in the Veterans Administration study reports (1967 and 1970) had no effect on workup, compliance, or blood pressure decline. Furthermore, no significant relationship was found between blood pressure reduction and medical process, therapeutic regimens, or patient compliance. These data suggest that, in contrast to experience obtained in programs specifically designed for long-term management of this chronic disease, the present-day general medical clinic cannot satisfy the needs of most hypertensive patients.

Follow-Up Studies↗