| Objective: Hypertension is a high risk factor of cardiovascular and cerebrovascular diseases,accounting for a large proportion in chronic non-communicable diseases.Blood pressure control is stable and up to the standard,which can significantly reduce the incidence,disability and mortality of acute and chronic cardiovascular and cerebrovascular events.In addition to reasonable antihypertensive plan and healthy lifestyle,comprehensive treatment of hypertension should strengthen blood pressure monitoring to improve the hypertension patients blood pressure compliance rate and blood pressure stability.A number of studies at home and abroad have shown that home blood pressure monitoring is a feasible blood pressure monitoring method,which provides convenience for patients and can timely reflect the real blood pressure of patients.It has a very good effect in the daily blood pressure monitoring of patients with chronic hypertension.Remote home blood pressure monitoring is mainly refers to using intelligent means of informatization,the patients blood pressure monitor at home over a wireless network connection,and blood pressure management system after a patient at home blood pressure self-test,automatically uploaded to the mobile terminal equipment and data through the network transfer repository,clinical observer can browse data anytime and anywhere,and to evaluate blood pressure data,according to the timely intervention on the patients,patients' families after binding mobile phone APP can instantly receive blood pressure measurement information,create a good environment for home blood pressure monitoring support,let patients,clinicians and patients families joint efforts for the control of hypertension.Family doctors can sign contracts with patients to form a closedoctor-patient relationship.Family doctors can make timely home visits according to patients' blood pressure fluctuations,and assist patients to refer to higher hospitals when necessary to achieve the purpose of hierarchical diagnosis and treatment.This paper preliminarily explored the therapeutic effect of remote home blood pressure monitoring combined with mobile phone APP and cross-district family doctor contract on community hypertension management,so as to provide more basis and methods for community hypertension and chronic disease management.Methods:In the hypertension and chronic disease management platform of a community health service center in a city,45 patients diagnosed with hypertension and whose blood pressure control was not up to standard were selected and divided into the control group(30 cases)and the intervention group(15 cases).In the outpatient department of cardiovascular medicine of the third-grade a hospital,15 patients who failed to reach the standard were selected and included in the intervention group with the consent of the patients.Control for home blood pressure self-test,not signing for family doctors,each patient all leasing intelligent electronic sphygmomanometer,requirements into the group of patients with high blood pressure every day morning,just before bed,measuring blood pressure two to three times,adopt the unified specification notebooks blood pressure,blood pressure patients according to the situation of blood pressure measurement decides whether to community consultation and adjusted step-down scheme;In the intervention group,remote home blood pressure monitoring was carried out,and each patient was bound to the doctor's mobile APP.All the 15 patients in the jurisdiction were family doctor contract patients,and the 15 patients outside the jurisdiction were signed for free family doctor service after informed consent.Each patient,the intervention group were smart sphygmomanometer lease agreement,after a patient at home blood pressure self-test,upload real-time automatic measurement information to the cloud server,community doctors according to the situation of mobile phone APP blood pressure on the assessment andmanagement,necessary to carry on the family visit to patients with appointments,in order to know more about the patient's blood pressure measurement and the patient's family support environment,targeted health education for the patient,guide the patient blood pressure measurement and drug treatment..After 1 month,3 months,6 months and 12 months,the patients in each group were observed and compared in terms of blood pressure drop,blood pressure compliance,blood pressure stability,medication compliance and blood pressure measurement times.Results: After 1 month,3 months,6 months and 12 months,the blood pressure of the control group and the intervention group was significantly improved(P<0.05),the blood pressure of SBP and DBP decreased more in the intervention group than in the control group(P<0.05).The compliance rate of blood pressure in the intervention group was higher than that in the control group(P<0.05).The drug compliance of the intervention group was better than that of the control group after 12 months of intervention.The number of measurements in the intervention group was more than that in the control group(P<0.05),and the difference between the two groups was statistically significant.The analysis of the intervention group and the central Asia group showed that there was no statistical difference in the indicators of cross-regional signing and regional signing,and remote home blood pressure monitoring could provide good monitoring effect.Conclusion: The new model of remote home blood pressure monitoring combined with mobile APP management and cross-regional family doctor contract,it can effectively control the blood pressure level of patients with hypertension in the community,increase the medication compliance of patients with hypertension,and promote patients to measure blood pressure more;it can break the geographical restrictions and serve more hypertension patients by signing contracts with cross-district family doctors,so as to make the blood pressure control more stable andworthy of promotion and application in the comprehensive management of hypertension in the community. |
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