目的:探讨运用智能手机和智能血压计构建的远程血压管理系统对在职高血压患者血压管理的效果。方法:纳入2020年10月至2021年5月在内蒙古科技大学包头医学院第二附属医院门诊就诊的高血压患者共246名,根据患者是否愿意购买智能血压计分为远程管理组154名和常规管理组92名。远程管理组通过远程血压监测系统进行血压管理,常规管理组采用传统门诊管理模式进行管理,比较两组患者的血压、用药依从性和血压达标率的变化。结果:经过3、6个月管理,常规管理组的收缩压分别为(139.8±9.2)、(132.6±6.4) mmHg,舒张压分别为(89.5±9.1)、(83.7±4.5 )mmHg,远程管理组的收缩压分别为(131.6±10.5)、(130.3±8.0)mmHg,舒张压分别为(86.3±8.6)、(83.3±5.8)mmHg。随着管理时间延长,两组患者的收缩压和舒张压均降低,且保持下降的趋势(均P＜0.05)。经过6个月管理,远程管理组在降低收缩压方面优于常规管理组(P＜0.05),而两组患者的舒张压下降无差异(P＞0.05);两组患者依从性均有所提高,但远程管理组用药依从性优于常规管理组(均P＜0.05);两组患者的血压达标率均提高(常规管理组:29.9 % vs 37.0 %,远程管理组:42.9 % vs 50.6 %),且远程管理组的血压达标率优于常规管理组(均P＜0.05)。结论:基于智能手机APP和智能血压计的远程管理可以有效降低在职高血压患者的收缩压,提高患者用药依从性,提高血压达标率,该模式可以考虑应用于在职高血压患者血压管理中。
Objective: To explore the effect of the telemonitoring blood pressure management system constructed by smartphone and smart blood pressure monitor on blood pressure management of working hypertension patients. Methods: A total of 246 hypertensive patients who visited the Second Affiliated Hospital of Baotou Medical College from October 2020 to May 2021 were included, they were divided into groups according to whether they were willing to purchase smart blood pressure monitors. A total of 154 patients were included in the monitoring management group, and 92 patients who did not purchase smart sphygmomanometers were included in the routine management group. The changes in blood pressure, drug adherence and blood pressure control rate between the two groups were compared. Results: After 3 months and 6 months of management, the systolic blood pressure in the routine management group was (139.8±9.2)mmHg and (132.6±6.4)mmHg, and the diastolic blood pressure was (89.5±9.1)mmHg and (83.7±4.5)mmHg, respectively, and the systolic blood pressure in the telemonitoring management group was (131.6±10.5)mmHg and (130.3±8.0)mmHg, respectively. The diastolic blood pressure was (86.3±8.6)mmHg and (83.3±5.8)mmHg, respectively, and the systolic and diastolic blood pressure decreased in both groups as the management time was prolonged and maintained a decreasing trend (both P＜0.05). After 6 months of management, the telemonitoring management group was better than the routine management group in reducing systolic blood pressure (P＜0.05), while there was no difference in the decrease of diastolic blood pressure between the two groups (P＞0.05). After 6 months of management, the drug adherence of both groups improved, but the adherence of the telemonitoring management group was better than that of the routine management group (both P＜0.05). After 6 months of management, the blood pressure control rate increased in both groups (routine management group: 29.9 % vs. 37.0 %, telemonitoring management group: 42.9 % vs. 50.6 %), and the blood pressure control rate was better in the telemonitoring management group than in the routine management group (both P＜0.05). Conclusion: The telemonitoring management based on smartphone APP and smart sphygmomanometer can effectively reduce the systolic blood pressure of working hypertensive patients, improve the drug adherence and improve the blood pressure control rate. This model can be considered for working hypertensive patients.
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