| Objectives:To evaluate patient reported outcomes of hypertension patients by using the evaluated patient reported outcomes(PRO)scale of hypertension patients.To establish the minimum clinically significant difference(MCID)of PRO,which is used to judge the clinical significance of the difference of PRO scores.To analyze the difference of PRO score between different hypertension medication schemes and different blood pressure levels,and put forward the treatment method suitable for patients with hypertension from psychological,physiological and social perspectives,so as to provide reference for clinical medication and intervention research of patients with hypertension.Methods:During May 2020 to October 2020,hypertension patients in Baoshan City(Changning County,Longling County,Shidian County)and Yuanjiang County of Yuxi City in Yunnan Province were investigated with the questionnaire of hypertension patients reported outcomes(including chronic measurement scale system in hypertension PRO scale PROISCD PRO-HY(V1.0),basic conditions,health and lifestyle four parts).604 patients with hypertension in community were assessed by questionnaire twice,and physical examination was carried out.Subjective criteria and distribution methods were used to determine the minimum clinical importance difference(MCID)of PRO for hypertension.Two-factor analysis of variance was used to analyze the PRO differences among different drug regimens and blood pressure levels in the first survey.Results:1.In the total score of the PRO scale and all fields,the subjects scored the highest in the specific module,the lowest in the spiritual/faith health field,and there was no significant difference in the scores of other fields.Among all aspects of PRO,the score of treatment side effect was the highest,followed by the score of activity ability and limitation,the score of special psychological life influence and positive emotion was relatively low,and the score of belief the lowest.2.Minimum Clinical Importance Difference(MCID):The positive change value of MCID of PRO scale for hypertension patients was determined by using the subj ective criterion method in anchor method and the ES method in distribution method as physical health 7.11,mental health 7.05,social health 6.99,spiritual belief health 8.17,common module 4.99,specific module 7.10,and total scale score 5.01.The negative change values were physical health-9.01,mental health-9.91,social health-9.19,spiritual belief health-10.25,common module-6.33,specific module-6.83,and total scale score-5.28.3.Differences in PRO fields among hypertension patients with different medication regimens and blood pressure levels:there was no interaction between total scale score and all fields.Medication scheme:The total score,common module and social health score of single drug were higher than those of traditional compound preparation.The physical health scores of monotherapy were higher than those of combination drugs.Blood pressure level:the specific module score for grade 1 hypertension is higher than that for grade 3 hypertension.4.Differences in PRO side among hypertension patients with different medication regimens:the scores of basic functional state,interpersonal communication and social support of single medication were higher than those of traditional compound preparation;the score of basic functional status of single drug was higher than that of combination drugs.In grade 2 hypertension,the scores of mobility and limitation of single drug and combination drugs were lower than those of traditional compound drug.In grade 3 hypertension,the scores of mobility and limitation of monotherapy were higher than those of combination drugs,and the scores of negative emotion of monotherapy were lower than those of combination drugs.5.Differences in PRO side among hypertension patients with different blood pressure levels:the positive emotion score of grade 1 hypertension was lower than that of grade 2 hypertension;the scores of cerebrovascular system symptoms of grade 1 hypertension were higher than those of grade 3 hypertension.The scores of treatment side effects and special psychological effects of grade 2 hypertension were higher than those of grade 3 hypertension.The scores of activity ability and limitation in grade 1 and grade 2 hypertension were lower than those in grade 3 hypertension with single drug use,and the scores of negative emotion in grade 1 hypertension were higher than those in grade 2 and grade 3 hypertension with single drug use.In combination medication,the score of negative emotion of grade 1 hypertension was lower than that of grade 3 hypertension.The scores of mobility and limitation in grade 1 hypertension were lower than those in grade 2 hypertension in traditional combination formulations.Conclusions:1.The PRO scores of community hypertension patients who are taking antihypertensive drugs evaluated in this study can provide reference for other scholars to conduct PRO studies on hypertension in the future.2.In this study,the minimum clinically important difference(MCID)of the PRO scale for hypertension patients was determined using the subjective anchor method and the ES method in the distribution method.Since there is no gold standard for the estimation method of MCID at present,and the formulation of MCID is related to many factors such as the methods and object selected,the suggestions of scholars are also different.Therefore,how to apply MCID in clinical research and whether the application of indicators is effective are the problems that need to be solved in the next research.3.There were differences in PRO among hypertension patients with different medication regimens and blood pressure levels.In the total score,common module and social health of PRO in community hypertension patients,single drug was better than traditional compound preparation.In the specific module dimension,the specific module score of grade 1 hypertension was higher than that of grade 3 hypertension.Monotherapy was higher than combination therapy in grade 3 hypertension,both in mobility and limitation.On the negative emotional side,grade 1 hypertension was higher than grade 2 hypertension and grade 3 hypertension on a single drug.4.The recommended treatment combination for patients with hypertension,from the perspective of physical health area mobility and limitations,is grade 3 hypertension&single drug>grade 3 hypertension&combination medication.From the perspective of negative emotions in the field of mental health,single drug&grade 1 hypertension>single drug&grade 2 hypertension,single drug&grade 3 hypertension.5.The combination of minimum clinically important difference(MCID)and statistical difference can comprehensively evaluate PRO changes hypertension patients treated with different medication regimens. |
PDF Full Text Request