Effect Of Hospital And Community Comprehensive Management Mode On Compliance And Blood Pressure Control In Hypertension Patients

Objective:To investigate the effect of hospital and community comprehensive management mode on compliance and blood pressure control in hypertension patients, and provide foundation for effective control of the blood pressureMethod:The study used the method of random sampling, we choosed112(male, n=55; female, n=57) primary hypertension patients who were able to offer informed consent out of1745hypertension patients managed by Community Health Service Center of District Guanshaling Changsha City, from June2011to August2011. We divided the patients into two groups according to the random number method,56patients for control group and56for treatment group, all patients signned the informed consent, we assessed the general condition, life style, status of hypertension control, acknowledge of blood pressure monitoring, medicine management and compliance of medical treatment according to the 《HILL-BONE HIGH BLOOD PRESSURE COMPLIANCE SCALE》 and our independent designed《basic information》,《ambulatory blood pressure monitoring》. We built the databases for treatment group, the treatment plans were adjusted by the chief and associate chief physicians of our hospital, we conducted patients’measure the blood pressure, sent them mercurial sphygmomanometers, stethoscopes and the sheets for recording, we also sent them the educational books for healthy life style conducting.We sent the chief and associate chief physicians, nurses specializing in hypertension, workers in community health center to follow up the patients in control group, We focused on the management of medicine use, and the status of pressure control and the existing problems, and our physicians gave advices for the treatment and health education when necessary.We collected subjective and objective data of the two groups at the first week and the twelfth week, then checked and entered SPSS13.0statistical software for further analysis. Result:The blood pressure base line of the community patients indicated that the control rate of hypertension in the112patients was17%, male female ratio was55VS57. The acknowledge of blood pressure monitoring and the compliance rate was50.9%. The compliance rate of HILL-BONE hypertension was53.8%. Reasonable drug management rate was25.9%. General state of patients affect the hypertension control rate, acknowledge and compliance for treatment, there were positive correlations between monitoring the blood pressure and the compliance of drug use. Single factor and multiple factors unconditioned Logistic regression analysis indicated that rational medical treatment, blood pressure monitoring, life style and acknowledge of treatment were the four important influentied actors of pressure control. Hypertension control rate, monitoring the blood pressure and the compliance of drug use were not statistical significance in both groups before intervention.Intervention results:after general intervention from community to hospital, the blood pressure control rate of experiment group rose from17.9%to75%, compliance rate of pressure monitoring rose from51%to78.6%, rational drug treatment rate rose from26.8%to89.5%. The blood pressure control rate of control group rose from16.9%to18.5%, compliance rate of pressure monitoring rose from50.8%to54.7%, compliance rate of HILL-BONE hypertension rose from53.3%to54.3%, rational drug treatment rate rose from25%to28.1%.The randomized controlled study indicated that:blood pressure control rate, acknowledge of hypertension and compliance rate, rational drug use rate and prognosis were obvious better than the control group, the results were responsible for statistically significant(p<0.01).Conclusion:The blood pressure control rate, acknowledge of pressure monitoring and status of compliance, compliance rate of HILL-BONE hypertension, rational drug use rate are generally low among community hypertension patients. Rational medical treatment, blood pressure monitoring, life style and acknowledge of treatment are the four important influentied factors of pressure control.After the intervention which we took every two weeks in the last three months, the blood pressure control rate, acknowledge of pressure monitoring and status of compliance, compliance of drug treatment, rational drug use rate rose obviously. The hospital-community management mode was worth learning and popularizing.