Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.
Front Public Health. 2024 Aug 2;12:1428310. doi: 10.3389/fpubh.2024.1428310. eCollection 2024.
Hypertension is rapidly increasing in China, but control rates are significantly low. There is a pressing need for effective management models in primary community health settings.
In April 2023, 459 patients from six communities in Jinan City were enrolled using a multi-stage random sampling method and assigned to either a control group comprising 243 participants or an intervention group comprising 216 participants. The control group received standard hypertension care, whereas the intervention group participated in a novel IoT-based remote blood pressure monitoring program for 6 months. Data collection was conducted through detailed questionnaire surveys, cloud platform records, and community management records, both before and after the intervention period. The study employed difference-in-differences (DID) and mediation effect models to assess the effects of the IoT-based management model.
The DID model demonstrated that the intervention significantly reduced systolic blood pressure by 9.883 mm Hg and diastolic blood pressure by 6.553 mm Hg. The mediation effect model showed that the frequency of blood pressure measurement and attitudes and beliefs toward hypertension treatment had mediating effects, accounting for 5.82 and 8.07% of the total effect, respectively. The heterogeneity analysis revealed significant regional differences: rural residents experienced a greater decrease in systolic and diastolic blood pressures by 14.85 mm Hg and 6.591 mm Hg, respectively, compared to urban residents, whose diastolic pressure decreased by 6.046 mm Hg.
It is advisable to develop differentiated hypertension management strategies tailored to specific regional needs to promote the deep integration and widespread application of smart blood pressure monitoring technology. Enhancing patient awareness and capabilities in managing their health condition is crucial for improving the blood pressure control level among community hypertension patients.
高血压在中国迅速增加，但控制率显著较低。在基层社区卫生环境中，迫切需要有效的管理模式。
2023 年 4 月，采用多阶段随机抽样法，从济南市 6 个社区招募了 459 名患者，将他们分为对照组（243 名）和干预组（216 名）。对照组接受标准高血压护理，而干预组则参与了为期 6 个月的新型物联网远程血压监测计划。在干预前后，通过详细的问卷调查、云平台记录和社区管理记录收集数据。采用差分（DID）和中介效应模型评估基于物联网的管理模式的效果。
DID 模型表明，干预组显著降低了 9.883mmHg 的收缩压和 6.553mmHg 的舒张压。中介效应模型显示，血压测量频率以及对高血压治疗的态度和信念具有中介效应，分别占总效应的 5.82%和 8.07%。异质性分析显示，农村居民的收缩压和舒张压分别下降了 14.85mmHg 和 6.591mmHg，而城市居民的舒张压下降了 6.046mmHg，城乡差异显著。
针对特定地区的需求，制定差异化的高血压管理策略，促进智能血压监测技术的深度融合和广泛应用。提高患者对管理自身健康状况的认识和能力，对于提高社区高血压患者的血压控制水平至关重要。
