通过基于手机的自我管理支持系统报告的血压与药物摄入、幸福感、压力、身体活动及症状之间的关联:一项初级保健队列研究

Links between blood pressure and medication intake, well-being, stress, physical activity and symptoms reported via a mobile phone-based self-management support system: a cohort study in primary care.

作者信息

Taft Charles, Hallberg Inger, Bengtsson Ulrika, Manhem Karin, Kjellgren Karin

机构信息

Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

BMJ Open. 2018 Aug 23;8(8):e020849. doi: 10.1136/bmjopen-2017-020849.

Abstract

OBJECTIVES

To explore relationships between patients' self-monitoring of blood pressure (BP) and their concurrent self-reports of medication intake, well-being, stress, physical activity and symptoms.

DESIGN

This study is a secondary analysis of a prospective study exploring the 8-week effectiveness of a mobile phone-based self-management support system for patients with hypertension.

SETTING

Four primary healthcare centres situated in urban and suburban communities in Sweden.

PARTICIPANTS

50 patients undergoing treatment for hypertension.

PRIMARY AND SECONDARY OUTCOME MEASURES

Associations between systolic (SBP) and diastolic blood pressure (DBP) and 10 self-report lifestyle-related variables were analysed using linear mixed effects modelling.

RESULTS

Medication intake, better well-being, less stress and greater physical activity were associated variously with lower same-day SBP and DBP. The single strongest association was found between medication intake and SBP, where failure to take medications was associated with an estimated 7.44 mm Hg higher SBP. To a lesser degree, medication intake was also associated with DBP, where DBP was 4.70 mm Hg higher in cases where medications were not taken. Well-being and stress were consistently associated with SBP and DBP, whereas physical activity was associated with only SBP. None of the symptoms-dizziness, headache, restlessness, fatigue or palpitations-were significantly associated with BP.

CONCLUSIONS

Our findings that BP was associated with patients' BP management behaviours and experiences of well-being and stress, but not symptoms suggest that enabling persons with hypertension to monitor and track their BP in relation to medication intake, physical activity, well-being, stress and symptoms may be a fruitful way to help them gain first-hand understanding of the importance of adherence and persistence to treatment recommendations.

TRIAL REGISTRATION NUMBER

NCT01510301; Pre-results.

摘要

目的

探讨患者自我血压监测(BP)与同时期自我报告的药物摄入、幸福感、压力、身体活动及症状之间的关系。

设计

本研究是一项前瞻性研究的二次分析,该前瞻性研究探讨了基于手机的自我管理支持系统对高血压患者的8周有效性。

地点

瑞典城市和郊区社区的四个初级医疗保健中心。

参与者

50名接受高血压治疗的患者。

主要和次要结局指标

使用线性混合效应模型分析收缩压(SBP)和舒张压(DBP)与10个自我报告的生活方式相关变量之间的关联。

结果

药物摄入、更好的幸福感、更少的压力和更多的身体活动分别与同日较低的SBP和DBP相关。药物摄入与SBP之间的关联最为显著,未服药与SBP估计高出7.44 mmHg相关。在较小程度上,药物摄入也与DBP相关,未服药时DBP高出4.70 mmHg。幸福感和压力始终与SBP和DBP相关,而身体活动仅与SBP相关。头晕、头痛、烦躁、疲劳或心悸等症状均与血压无显著关联。

结论

我们的研究结果表明,血压与患者的血压管理行为、幸福感和压力体验相关,但与症状无关,这表明让高血压患者监测和跟踪其血压与药物摄入、身体活动、幸福感、压力和症状的关系,可能是帮助他们直接了解坚持治疗建议的重要性的有效方法。

试验注册号

NCT01510301;预结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/662c/6112389/bc1519862332/bmjopen-2017-020849f01.jpg

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