家庭医生责任制对社区高血压患者治疗依从性及降压疗效的影响

Effects of Responsibility System of Family Doctors on the Treatment Compliance and Antihypertensive Efficacy of Community Hypertension Patients

目的观察运用家庭医生责任制(responsibility system of family doctors,RSFD)干预方法对治疗社区高血压患者(HTN)的效果。方法随机抽选在我院管辖范围内的240例HTN患者,进行随机分配:A组作为干预组,共120例患者,均采用RSFD服务方式,患者与所在社区的健康服务站签订合法协议,家庭医生为患者提供专业化的服务模式,包括对患者进行健康评估、制定计划、健康教育、行为等综合干预;B组为对照组,采用常规管理模式。观察比较两组患者的治疗依从性、降压疗效。结果 A组患者治疗后的收缩压(SBP)为(134.1±8.3)mm Hg,舒张压(DBP)为(82.1±6.3)mm Hg,明显低于对照组患者(P<0.05)。在10个月后的随访调查中发现,A组患者血压控制方面表现优异,原因在于在控制自己饮食、规律服药、高血压知识良好掌握、运动状况以及血压监测方法正确等方面做到治疗的依从性;B组患者效果不显著,两组对比具有统计学意义(P<0.05)。结论 RSFD对社区HTN患者的治疗效果显著,临床上值得推广采用。

Objective To explore the effects of responsibility system of family doctors（RSFD） on the treatment compliance and antihypertensive efficacy of community hypertension（HTN） patients. Methods 240 cases of HTN patients in our community were selected and divided into group A（RSFD service mode） and group B（conventional management mode）. RSFD service： A legal agreement was signed between the patients and community health service station; Family doctors provided specialized comprehensive intervention for patients,including health assessment, planning, health education and behavior education. The treatment compliance and antihypertensive efficacy of two groups were compared. Results After intervention, the systolic blood pressure（SBP） and diastolic blood pressure（DBP） of group A were（134.1 ± 8.3） mm Hg and（82.1 ± 6.3） mm Hg respectively, significantly lower than those of group B（P〈0.05）. It was found in the follow-up survey 10 months later that the performance of blood pressure of patients in group A was outstanding. The reason was that the patients could control their diet and take medication regularly and had a good knowledge of hypertension and their movement status and blood pressure monitoring method were correct. But the clinical effect of patients in group B was not significant. The differences between two groups was statistically significant（P〈0.05）. Conclusions The curative effect of RSFD in treatment of patients with HTN is significant in community.