| ObjectiveResistant hypertension,as a special type of hypertension,has the characteristics of difficult to control blood pressure,high cardio-cerebral-kidney complications,and high mortality,which brings huge economic burden to public health services and families.How to manage such patients scientifically and efficiently has been the focus of research in cardiovascular experts.This study intends to use modern communication technology to develop and establish a resistant hypertension management system,explore its management effect on resistant hypertension patients from multiple dimensions,and conduct cost/benefit analysis and evaluation,providing a valuable practical reference for further clinical promotion.Methods1.The meta-analysis was used to evaluate the impact of remote health interventions based on modern communication technology on patients with hypertension.The database was first searched by a computer,the researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the research.Finally,statistical data analysis is performed to provide a theoretical basis for remote health intervention in patients with resistant hypertension.2.Consecutive cases of resistant hypertension in the outpatient department and hospitalization of the First People’s Hospital of Yangzhou were selected.The self-developed network information platform was used to use the electronic sphygmomanometer of the mobile intelligent terminal using modern communication technology.Through the dynamic monitoring of patients’ blood pressure,regular follow-up,healthy living behavior education and guiding scientific and rational use of drugs,an integrated and standardized management system for resistant hypertension patients is established.3.Consecutive patients with resistant hypertension were randomly selected.The control group was treated with conventional resistant hypertension.The observation group was managed with a resistant hypertension follow-up system.The follow-up period was 1 year.The total cost of the two groups was compared.The annual incidence of new cardiovascular and cerebrovascular events was compared,the cost/effect,cost/utility of the two groups were analyzed with reference to this incidence.Results1.Finally,22 articles were included.The meta-analysis showed the remote health intervention group based on the modern communication technologies(Internet or mobile communication network)had lower systolic blood pressure than the control group and was closer to the control group than the conventional health care intervention group.The normal systolic blood pressure range,the difference between the two groups of results was statistically significant;the diastolic blood pressure of patients with hypertension was lower than the control group,and closer In the range of normal diastolic blood pressure,the difference between the two groups was statistically significant.Knowledge of hypertension prevention and awareness,the rate of medication according to doctor’s advice,the proportion of patients who regularly measure blood pressure,the proportion of patients who insist on reasonable diet,the proportion of patients who quit smoking and alcohol withdrawal,and the proportion of patients who actively control body weight in the normal range in remote health intervention group compared with control group,there are differences,and the difference is statistically significant.2.After 1 year follow-up evaluation,the system was running well and the data was stable.Compared with pre-administration,the healthy lifestyle of patients with resistant hypertension was significantly improved,and the smoking rate and the drinking rate significantly decreased;The low salt dietary rate and medication compliance increased significantly;the average systolic blood pressure after 24 hours of system management,24h average coefficient of variation of diastolic blood pressure and 24h systolic blood pressure was significantly reduced;Early morning blood pressure significantly decreased after system management and the morning blood pressure compliance rate was significantly higher than before management.3.The incidence rate of cardiovascular and cerebrovascular events in the control group was significantly higher than the observation group.The total cost of follow-up for 1 year was used as the cost.The proportion of patients with no cardiovascular and cerebrovascular events at the 12th month of follow-up was the result.The results showed that for each additional unit effect,818.3 yuan was paid more than the control group.Sensitivity analysis showed The consistency result is obtained;the quality adjusted life year(QALY)is used as the utility index,and the cost required for the unit QALY is obtained.For each additional unit QALY of the control group,the cost is increased by 188.7 yuan,and the sensitivity results are basically the same.The observation group obtains the unit QALY.The cost is lower than the control group.Conclusion1.Meta-analysis results show that for hypertensive patients,the remote health.intervention model based on the modern communication technologies(Internet or mobile communication network)can better control blood pressure and improve patient compliance than traditional medical intervention mode.2.The system is stable and simple,system management has a significant effect on promoting healthy lifestyle,long-term scientific and rational medication and effective blood pressure control for patients with resistant hypertension,suitable for long-term comprehensive intervention management of resistant hypertension.3.The follow-up management system based on modern intelligent communication network technology manages interventions in patients with resistant hypertension,which can realize real-time communication between doctors and patients,meet the individual needs of patients,decrease the incidence of cardiovascular and cerebrovascular events,and reduce the unit QALY.The cost is required and the cost/effect is within an acceptable range.Finally,it has certain clinical application value. |
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