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To investigate the effectiveness of eTansiyon smartphone application in blood pressure control in patients with hypertension.
Background:
Global prevalence of hypertension and the burden of chronic illness care, especially in primary care, are increasing in world. We have developed eTansiyon to ensure the continuity of patient-physician relationship, so it may help to improve the lifestyle of patients with hypertension, increase their adherence to treatment and achieve the target blood pressure.
Methods:
This study was a non-randomized controlled study. The sample was selected by random sampling method among the patients registered in 6 Family Health Units (FHUs). Randomization was performed at the FHU level; the units were randomized to 4 control group (CG) and 2 intervention group (IG), so that randomization in this study was 2:1. Both groups were followed up for at least four months. In addition to CG, IG were provided to use eTansiyon. Obtained data were analysed to evaluate differences between groups at the beginning and end of the study, intra-group changes after follow-up and interaction between groups and follow-up period.
Findings:
The study was performed with 124 patients in CG and 61 patients in IG. At the end of the study, the average systolic blood pressure/diastolic blood pressure (SBP/DBP) of office and home was significantly lower in IG compared to CG (P < 0.001, MD 9.5 mmHg; P = 0.007, MD 3.8 mmHg; P < 0.001, MD 10.6 mmHg; P < 0.001, MD 4.8 mmHg, respectively), and it was found that the proportion of people with target blood pressure in IG was significantly higher than CG (P < 0.001, 49.2%(n = 30) and 22.6%(n = 28), respectively). Repeated measures ANOVA and generalized estimating equations results showed that follow-up period and interaction between groups were significant in terms of office and home SBP/DBP and target blood pressure level during follow-up period (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.024, respectively).
This study aimed to evaluate the effectiveness of hypertension management and analyse the factors associated with blood pressure reduction within China’s primary healthcare system.
Background:
Hypertension is one of the leading risk factors for global disease burden and is strongly associated with cardiovascular diseases. In China, hypertension is a serious public health problem, but few studies have evaluated the effectiveness of hypertension management in China’s primary healthcare system.
Methods:
The study sites were 24 primary healthcare institutions, selected using multistage stratified random sampling method. In each institution, hypertension patients aged at least 35 years who agreed to participate and had no disabilities or mental health problems were enrolled for hypertension management. Participants received comprehensive interventions in the primary healthcare system via a team. After a one-year intervention, data from 6575 hypertension patients were analysed to check the effectiveness of hypertension management and examined factors associated with hypertension control.
Findings:
There was an overall mean reduction of 4.5 mmHg in systolic blood pressure (SBP) and 1.9 mmHg in diastolic blood pressure (DBP). The blood pressure reduction after one year was greater in rural patients than in urban patients, 6.6 mmHg versus 3.4 mmHg for SBP and 2.6 mmHg versus 1.6 mmHg for DBP, respectively. The hypertension control rate also increased more in rural areas (22.1%) than in urban areas (10.6%) after the one-year intervention. Age, body mass index, region and being in an urban area had a significant negative association with the reduction of SBP (P < 0.05). Education level and baseline SBP showed a significant positive association (P < 0.05).
Conclusions:
Community-based hypertension management by general practitioners was feasible and effective. The effectiveness of hypertension management in rural areas was greater than in urban areas. Intervention strategies should pay more attention to patients in rural areas and western China.
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