Maryland Medical School to look at better treatment options for black diabetes and hypertension patients

Black Issues in Higher Education, April 21, 2005

BALTIMORE

A five-year study will look at whether teaching doctors about the latest diabetes and hypertension treatment guidelines and providing counseling for their Black patients will help the patients better manage their conditions.

Researchers hope to gain better control of the diseases by promoting early diagnosis and comprehensive treatment. The study is focusing on Blacks because they are at higher risk for developing the two conditions.

The American Diabetes Association says 11.4 percent of Blacks over age 20 have diabetes, compared with 6.3 percent of the general population. Four out of 10 Black Americans, meanwhile, have high blood pressure, compared with about three out of 10 Whites.

In addition to a higher incidence of the two conditions, treatment is often not as successful for Black patients.

For example, only 40 percent of Blacks treated for hypertension are able to meet goals for reduced blood pressure levels, compared to 54 percent of Whites, said the study's principal investigator, Dr. Elijah Saunders, a cardiologist at the University of Maryland Medical Center.

"That disturbs us," Saunders says. "We have improved the detection of high blood pressure. Most people are being treated, but the control rates have not done as well."

The study by the University of Maryland School of Medicine and the Bon Secours Baltimore Health System is being paid for with a $3 million grant from the National Heart, Lung and Blood Institute.

Researchers will follow two groups of 800 patients. High blood pressure patients will be cared for by University of Maryland physicians and diabetes patients will be cared for by Bon Secours doctors.

Half of the doctors and half of the patients will receive specialized education.

A team of experts from the two institutions will give half of the doctors regularly scheduled 90-minute classes that will include the most recent national guidelines for treating and managing the diseases. Half of the patients, meanwhile, will receive 30 minutes of instruction and counseling from a nurse as a part of each visit. The counseling will include discussion of healthy diet and lifestyle choices and the importance of taking medication as prescribed.

The doctors and patients who do not receive education or counseling will provide, and receive, regular care.

Saunders says the researchers hope to "empower the patient to understand their disease" and to take responsibility for their health.

"We have to improve the health care system comprehensively, not just doctors, not just nurses," he says.

Dr. Fadia Shaya, an assistant professor at the University of Maryland School of Pharmacy and one of the principal investigators of the study, says the researchers hope to bridge the gap between those who conduct research and those who provide care and learn "whether knowing better is going to make any difference."

Rep. Elijah Cummings, who is Black, noted during a press conference that many members of his family were affected by the two conditions.

"What is happening in this project will affect generations of yet unborn," the Baltimore congressman said.

Patients have to realize the connection between "the way we treat ourselves and our outcomes," Cummings said. "We're moving from problems to solutions.