Department of Family Medicine and Primary Health Care, Hospital Authority Kowloon West Cluster, New Territories, Hong Kong
Department of Family Medicine and Primary Health Care, Hospital Authority Kowloon West Cluster, New Territories, Hong Kong.
Postgrad Med J. 2022 Aug;98(1162):610-616. doi: 10.1136/postgradmedj-2020-139329. Epub 2021 May 26.
Little is known whether patients with lower health literacy could retain the practice and knowledge of home blood pressure monitoring (HBPM) after an educational programme.
A cluster randomised controlled trial in five primary care clinics recruited participants with uncontrolled hypertension. Clinics were randomised either to a HBPM group education (Risk Assessment and Management Programme (RAMP-group), or individual counselling of self-management (RAMP-individual). Health literacy was assessed by the Chinese Health Literacy Scale for Chronic Care. Practice and knowledge of HBPM were surveyed by a 10-item HBPM knowledge checklist and patient record review 6 months after interventions. Predictors for regular HBPM and good HBPM knowledge were assessed by multivariate logistic regression models.
287 participants (RAMP-group: 151; RAMP-individual: 136) were follow-up for 6 months. 272 participants completed the knowledge questionnaires (response rate 94.8%). 67.8% of the participants performed HBPM regularly, and there was no statistical difference between both interventions. Age more than 65 (adjusted odds ratios (aOR) 2.58, 95% CI 1.37 to 4.86, p=0.003), not working (aOR 2.34, 95% CI 1.10 to 4.97, p=0.027)and adequate health literacy (aOR 2.25, 95% CI 1.28 to 3.95, p=0.005) predicted regular HBPM. Participants in RAMP-group demonstrated a significant lower body weight than those in RAMP-individual (-0.3±2.0 kg vs +0.7 ±1.7 kg, p<0.001).The RAMP-group participants were eight times more likely to have full HBPM knowledge score than the RAMP-individual participants (aOR 8.46, 95% CI 4.68 to 15.28, p<0.001).
Patients could retain HBPM knowledge better after RAMP-group than RAMP-individual. Older, retired and patients with adequate health literacy were more likely to continue weekly HBPM 6 months after education.
NCT02551393.
对于接受了家庭血压监测（HBPM）教育项目的患者，其健康素养水平较低是否会影响他们对该项目的坚持和知识的掌握，目前还知之甚少。
在五家基层医疗机构开展了一项集群随机对照试验，纳入了血压控制不佳的患者。这些诊所被随机分为 HBPM 组教育（风险评估和管理方案（RAMP-组）或个体自我管理咨询（RAMP-个体）组。健康素养通过慢性病护理的中文健康素养量表进行评估。在干预 6 个月后，通过 10 项 HBPM 知识检查表和患者记录审查来调查 HBPM 的实践和知识。使用多变量逻辑回归模型评估定期 HBPM 和良好 HBPM 知识的预测因素。
287 名参与者（RAMP-组：151 名；RAMP-个体：136 名）随访 6 个月。272 名参与者完成了知识问卷（应答率 94.8%）。67.8%的参与者定期进行 HBPM，两种干预措施之间无统计学差异。年龄大于 65 岁（调整后的优势比（aOR）2.58，95%置信区间（CI）1.37 至 4.86，p=0.003）、不工作（aOR 2.34，95%CI 1.10 至 4.97，p=0.027）和适当的健康素养（aOR 2.25，95%CI 1.28 至 3.95，p=0.005）预测了定期 HBPM。RAMP-组的参与者体重比 RAMP-个体组低 0.3±2.0 公斤（p<0.001）。与 RAMP-个体组相比，RAMP-组的参与者有 8 倍的可能获得完整的 HBPM 知识评分（aOR 8.46，95%CI 4.68 至 15.28，p<0.001）。
与 RAMP-个体组相比，RAMP-组的患者在接受教育后对 HBPM 知识的掌握更好。年龄较大、退休和健康素养较高的患者在接受教育 6 个月后更有可能继续每周进行 HBPM。
NCT02551393。
