家庭医生签约服务对高血压患者血压控制率的影响

Influence of Contracted Service of Family Doctor on Blood Pressure Control Rate of Patients with Hypertension

目的探讨家庭医生签约服务对高血压患者血压控制率的影响。方法选取2017~2019年天津市和平区劝业场街林泉社区接受家庭医生签约服务的高血压患者1246例作为研究对象,分析社区管理人群血压控制率、体质指数、血脂情况及降压药物使用情况。结果2018年社区管理人群血压达标率高于2017年,差异有统计学意义(P<0.05);2019年社区管理人群血压达标率高于2017年,差异有统计学意义(P<0.05);2019年社区管理人群血压达标率高于2018年,但差异无统计学意义(P>0.05)。2017~2019年社区管理人群BMI比较,差异无统计学意义(P>0.05)。2017~2019年社区管理人群总胆固醇、甘油三酯、高密度脂蛋白胆固醇比较,差异无统计学意义(P>0.05);2018年、2019年低密度脂蛋白胆固醇与2017年比较,差异有统计学意义(P<0.05);2018年与2019年社区管理人群低密度脂蛋白胆固醇比较,差异无统计学意义(P>0.05)。2017~2019年高血压患者服降压药的种类(1种、2种、3种、4种)和不服药比较,差异无统计学意义(P>0.05);2017~2019年单片药物C、A、B、D使用占比比较,差异无统计学意义(P>0.05);2019年传统复方制剂使用占比低于2018年和2017年,差异有统计学意义(P<0.05);2019年新型复方制剂使用占比高于2017年和2018年,差异有统计学意义(P<0.05);2017~2019年C+A、C+B、A+D、A+B+C、A+C+D、A+B+C+D占比比较,差异无统计学意义(P>0.05)。结论家庭医生签约服务可有效控制高血压患者血压水平,提高高血压患者血压达标率,指导患者正确使用降压药物,提高治疗依从性。

Objective To explore the influence of family doctor contract service on blood pressure control rate of hypertensive patients.Methods From 2017 to 2019,1246 hypertensive patients in Linquan Community,Quanyechang Street,Heping District,Tianjin City were selected as the research objects to analyze the blood pressure control rate,body mass index,blood lipids and the use of antihypertensive drugs in the community management population.Results The blood pressure compliance rate of the community management population in 2018 was higher than that in 2017,the difference was statistically significant(P<0.05);the blood pressure compliance rate of the community management population in 2019 was higher than that in 2017,the difference was statistically significant(P<0.05);The blood pressure compliance rate of the community management population in 2019 was higher than that in 2018,but the difference was not statistically significant(P>0.05).There was no statistically significant difference in BMI of the community management population from 2017 to 2019(P>0.05).The total cholesterol,triglycerides,and high-density lipoprotein cholesterol of the community management population from 2017 to 2019 were not statistically different(P>0.05);There was a statistically significant difference in low-density lipoprotein cholesterol between 2018 and 2019 and 2017(P<0.05);there was no statistically significant difference in low-density lipoprotein cholesterol between 2018 and 2019 in community management population(P>0.05).There was no statistically significant difference between the types of antihypertensive drugs(1,2,3,4)taken by hypertensive patients from 2017 to 2019 and no medications(P>0.05);2017-2019 single drug C compared with the proportions of A,B,and D,the difference was not statistically significant(P>0.05);The proportion of traditional compound preparations used in 2019 was lower than that of 2018 and 2017,the difference was statistically significant(P<0.05);the proportion of new compound preparations used in 2019 was higher than that of 2017 and 2018,the difference was statistically significant(P<0.05);the proportions of C+A,C+B,A+D,A+B+C,A+C+D,A+B+C+D from 2017 to 2019 were not statistically significant(P>0.05).Conclusion The contracted service of family doctors can effectively control the blood pressure level of hypertensive patients,increase the rate of blood pressure compliance in hypertensive patients,guide patients to use antihypertensive drugs correctly,and improve treatment compliance.