Ernst Michael E, Bergus George R
Division of Clinical and Administrative Pharmacy, College of Pharmacy, The University of Iowa, Iowa City, Iowa, USA.
BMC Fam Pract. 2003 Oct 8;4:15. doi: 10.1186/1471-2296-4-15.
The use of ambulatory blood pressure monitoring (ABPM) in the diagnosis and management of hypertension in primary care settings in the United States is increasing. Insufficient information is available describing patients' experiences and acceptance of this technology in the United States, where medical insurance coverage of the procedure is often limited. The objective of this study was to describe patient satisfaction with ABPM performed in a primary care office in the United States, using modern ABPM technology.
Cross-sectional survey performed on consecutive patients referred to the ABPM service of the Family Care Center, University of Iowa Hospitals and Clinics, Iowa City, Iowa from January 2001 to July 2003. Measures of patient satisfaction and acceptance with the device, comfort, and overall session were assessed via a 9-question, Likert-scale response survey.
Since its inception two and a half years ago, 245 total ABPM sessions have been conducted in 235 unique patients. Of the 235 eligible respondents, 177 returned completed surveys, yielding a 75% response rate. Three-fourths (75%) of patients believed that undergoing the test was worthwhile considering the time and monetary cost involved, while most (90%) reported they thought the information provided by the test would be helpful to their physician in making treatment decisions. Patients reporting that their physician had clearly explained the benefit of undergoing the testing were more likely to report that they thought the results of the test would be more helpful in making treatment decisions. Few patients (20%) found that wearing the monitor was uncomfortable.
When clinically indicated, clinicians should not hesitate to order ABPM testing for fear of subjecting patients to an uncomfortable test, or an uncovered insurance benefit. When ordering ABPM, they should be sure to educate the patient about the potential benefits of undergoing the testing. Most patients believe the test will provide useful information in making treatment decisions, despite probable lack of insurance coverage, and appear willing to experience some discomfort for the overall gain of the results obtained from undergoing the session.
在美国基层医疗环境中，动态血压监测（ABPM）在高血压诊断和管理中的应用正在增加。在美国，关于患者对该技术的体验和接受情况的信息不足，而且该检查的医疗保险覆盖范围通常有限。本研究的目的是使用现代ABPM技术描述美国基层医疗诊所中患者对ABPM的满意度。
对2001年1月至2003年7月间转诊至爱荷华大学医院及诊所家庭护理中心ABPM服务的连续患者进行横断面调查。通过一项包含9个问题的李克特量表应答式调查评估患者对设备、舒适度及整个检查过程的满意度和接受度。
自两年半前开展以来，共对235名不同患者进行了245次ABPM检查。在235名符合条件的受访者中，177人返回了完整的调查问卷，回复率为75%。四分之三（75%）的患者认为考虑到所涉及的时间和金钱成本，进行该项检查是值得的，而大多数（90%）患者表示他们认为检查提供的信息将有助于医生做出治疗决策。报告称医生已清楚解释进行该项检查益处的患者更有可能表示他们认为检查结果在做出治疗决策时会更有帮助。很少有患者（20%）觉得佩戴监测仪不舒服。
当有临床指征时，临床医生不应因担心让患者接受不舒服的检查或保险未覆盖的益处而犹豫是否开具ABPM检查。开具ABPM检查时，他们应确保告知患者进行该项检查的潜在益处。尽管可能缺乏保险覆盖，但大多数患者认为该检查将为做出治疗决策提供有用信息，并且似乎愿意为了从整个检查过程中获得的结果而忍受一些不适。
