Exploration And Effect Evaluation Of Comprehensive Management Mode In Community For Hypertension Patients

Objective:Choose hypertension patients from one community in Jinan city for information collection,including basic information,blood pressure and complications,medication adherence,laboratory indexes,etc.Give them drug treatment,as well as the information management,medication guidance,health education and lifestyle guidance,regular follow-up,such as integrated mode management intervention,compared the patient's blood pressure control and the management success rate and patients' compliance rate and cardiovascular risk factors,lifestyle changes before and after management,and evaluate the effect,to explore suitable for actual situation this community integrated management mode of high blood pressure.Methods:Choice outpatients as the research object who have taking anti-hypertensive drug treatment of hypertension regularly from January 2017 to January 2018 in one community health service center in Jinan city,were randomly divided into experimental group and control group,both groups accept normative outpatient drug treatment,the experimental group at the same time to accept the comprehensive management of high blood pressure which established by this study.Issued "family self-test blood pressure chart","medication record chart","non-drug prescription","anxiety self-test scale",etc to the patients.Before all of the patients going into the group,collect related information and indicators first,the experimental group to fill in all the questionnaires,followed up for 1 year.Then compare the medication adherence rate,blood pressure control rates of anxiety,body mass index(BMI),fasting blood glucose,total cholesterol,low density lipoprotein cholesterol(LDL-C),triglycerides,smoking,drinking,exercise of the experimental group and control group patients.Data entry is conducted by using Excel table,and a database is established.Statistical aalysis was performed using SPSS17.0.The measurement data were expressed as mean plus or minus standard deviation.Comparison between measurement data sets,independent sample t test;The chi-square test is used to compare the rate before and after management.Paired t test was used for self-comparison before and after management.Rank sum test was used for ordinal data,and chi-square test was used for unordered data.Results:A total of 800 patients with hypertension were included in this study,including 400 in the management group and 400 in the control group.A year later,there were 754 cases of complete data left.380 in the management group and 374 in the control group.Management group compared with the previous:home blood pressure self-test rate(90.3%vs 29.5%),medication adherence rate(82.1%vs 36.3%),high blood pressure control(87.4%vs 43.7%)and the success rate(85.8%vs 28.7%)increased significantly,the difference was statistically significant(all P<0.01).Total cholesterol(82.1%vs 27.6%),low-density lipoprotein cholesterol(ldl-c)(85.0%vs 31.1%),triglycerides(86.6%vs 52.9%),fasting glucose success rate(94.5%vs 81.1%)obviously,the difference was statistically significant(all P<0.01).Smoking(11.6%vs 21.3%),drinking alcohol ratio(5.5%vs 13.9%)declined significantly,a low salt diet(75.5%vs 55.5%),exercise adherence(66.1%vs 41.8%)proportion rise obviously,anxious(29.7%vs 32.6%)decline,the difference was statistically significant(all P<0.01).Control group compared with the previous:no significant changes were observed(P>0.05 was not statistically significant).There was no significant change in overweight ratio in both groups(P>0.05 was not statistically significant).The proportion of rational drug use increased in both groups,but the increase was more significant in the experimental group(93.8%vs 32.1%)than that in the control group(47.3%vs 33.6%),the difference was statistically significant(all P<0.01).Conclusion:The standardized treatment and comprehensive management measures for community hypertension patients can significantly improve the treatment compliance,blood pressure control rate and compliance rate,effectively improve the patients' lifestyle,control cardiovascular risk factors to a certain extent,and have certain significance for the prevention and treatment of hypertension.