Sun G H, Shen M Z, Xu W H, Cao R H, Wang S S, Lu T T, Kong X X, Wang Y B, Cao F
Department of Cardiology, Second Medical Center of Chinese People's Liberation Army General Hospital, National Center for Clinical Medicine of Geriatric Diseases, Beijing 100853, China.
Hainan hospital of Chinese People's Liberation Army General Hospital, Sanya 572013, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2021 Nov 24;49(11):1089-1093. doi: 10.3760/cma.j.cn112148-20210615-00509.
To explore the effect of remote "Internet+" interactive management strategy on blood pressure control in patients with hypertension during normalized epidemic prevention and control of COVID-19. This is a randomized controlled study. A total of 394 patients with hypertension who were treated in Chinese People's Liberation Army General Hospital from October 2019 to December 2020 were randomly divided into experimental group (197 cases) and control group (197 cases). The experimental group adopted remote "Internet+" interaction mode to carry out remote blood pressure intervention, and the control group received traditional blood pressure control mode, and the intervention time was 6 months. Evaluation indicators included blood pressure level, blood pressure lowering speed, time to target blood pressure, blood pressure measurement times, communication times with doctors, medication compliance, blood pressure measurement compliance and disease awareness after 6 months of intervention. The evaluation indexes of the two groups were compared, and the bivariate Pearson correlation analysis was used to explore the relationship between the speed of blood pressure reduction and the times of blood pressure measurement and doctor communication in all patients. A total of 394 patients with hypertension were included in this study, including 209 males, aged (67.6±2.8) years old. After 6 months of intervention, the systolic and diastolic blood pressure of the two groups were both lower than the baseline blood pressure before intervention (both <0.05), the systolic blood pressure ((125.7±11.7) mmHg (1 mmHg=0.133 kPa) vs. (132.6±12.9) mmHg, <0.001) and diastolic blood pressure ((72.4±10.7) mmHg vs. (79.8±11.6) mmHg, <0.001) in the experimental group were lower than those in the control group. The blood pressure reduction speed of the experimental group was faster than that of the control group ((18.63±1.59) mmHg/d vs. (13.26±2.85) mmHg/d, <0.001), and the time to reach the target blood pressure in the experimental group was shorter than that in the control group ((23.69±2.93) d vs. (47.12±5.81) d, <0.001). Compared with the control group, the blood pressure measurement times ((0.98±0.13) times/d vs. (0.20±0.40) times/d, <0.05) and the number of communications with doctors ((0.97±0.16) times/week vs. (0.12±0.32) times/week, <0.05) were significantly higher in the experimental group. Correlation analysis showed that the speed of blood pressure reduction was positively correlated with the number of blood pressure measurements (=0.419, <0.01) and the number of communications with doctors (=0.857, <0.01). The proportion of standardized medication (93.91% (185/197) vs. 51.78% (102/197), <0.001), timely measurement (97.46% (192/197) vs. 47.21% (93/197), <0.001) and high-degree disease awareness (94.42% (186/197) vs. 49.24% (97/197), <0.001) were significantly higher in the experimental group than those in the control group. The remote "Internet+" interactive management strategy can effectively improve patients' blood pressure control. The doctor-patient interaction can improve medication compliance and measurement compliance of patients, and help shorten the time to reach the target blood pressure.
探讨在新冠肺炎常态化疫情防控期间,远程“互联网 +”互动管理策略对高血压患者血压控制的影响。这是一项随机对照研究。选取2019年10月至2020年12月在中国人民解放军总医院接受治疗的394例高血压患者,随机分为实验组(197例)和对照组(197例)。实验组采用远程“互联网 +”互动模式进行远程血压干预,对照组采用传统血压控制模式,干预时间为6个月。评估指标包括干预6个月后的血压水平、血压下降速度、达到目标血压的时间、血压测量次数、与医生沟通次数、用药依从性、血压测量依从性和疾病知晓率。比较两组评估指标,并采用双变量Pearson相关分析探讨所有患者血压下降速度与血压测量次数及与医生沟通次数之间的关系。本研究共纳入394例高血压患者,其中男性209例,年龄(67.6±2.8)岁。干预6个月后,两组收缩压和舒张压均低于干预前基线血压(均P<0.05),实验组收缩压((125.7±11.7)mmHg(1 mmHg = 0.133 kPa)vs.(132.6±12.9)mmHg,P<0.001)和舒张压((72.4±10.7)mmHg vs.(79.8±11.6)mmHg,P<0.001)均低于对照组。实验组血压下降速度快于对照组((18.63±1.59)mmHg/d vs.(13.26±2.85)mmHg/d,P<0.001),且实验组达到目标血压的时间短于对照组((23.69±2.93)d vs.(47.12±5.81)d,P<0.001)。与对照组相比,实验组血压测量次数((0.98±0.13)次/d vs.(0.20±0.40)次/d,P<0.05)和与医生沟通次数((0.97±0.16)次/周 vs.(0.12±0.32)次/周,P<0.05)显著增多。相关分析显示,血压下降速度与血压测量次数(r = 0.419,P<0.01)和与医生沟通次数(r = 0.857,P<0.01)呈正相关。实验组规范用药比例(93.91%(185/197)vs. 51.78%(102/197),P<0.001)、按时测量比例(97.46%(192/197)vs. 47.21%(93/197),P<0.001)和疾病知晓率高的比例(94.42%(186/197)vs. 49.24%(97/197),P<0.001)均显著高于对照组。远程“互联网 +”互动管理策略可有效改善患者血压控制。医患互动可提高患者用药依从性和测量依从性,并有助于缩短达到目标血压的时间。