区域医疗联合体高血压管理平台在社区的实践探索

Practice exploration of regional medical consortium hypertension management platform based on Internet in community hypertension

目的评价互联网+区域医疗联合体背景下的高血压管理平台在社区高血压管理中应用价值。方法采用随机对照研究方法,选取2017年1月至2018年11月,北京市海淀医院下属区域医疗联合体社区医院,594例新发现或已确诊为高血压病,但血压控制不达标的高血压患者。随机分为干预组与对照组,对照组常规门诊就诊指导和随访,干预组在此基础上,纳入区域医疗联合体高血压远程管理平台管理。干预时间为1年,主要比较两组患者在干预前后的生活方式、血压控制、血压达标率、药物治疗率、降压药物依从性的变化。结果共有575例高血压患者完成1年的随访,干预组291例,对照组284组。在干预1年后,干预组在增强体育锻炼方面及控制体重方面显著优于对照组(P<0.05)。两组患者收缩压及舒张压较基线均有显著减低,两组间对比,干预组收缩压及舒张压减低幅度、血压达标率、药物治疗率方面显著均优于对照组(P<0.05)。药物依从性方面,与对照组对比,干预组药物依从性显著增高(P=0.02)。结论互联网+区域医疗联合体背景下的高血压管理平台在社区高血压的防控作用优于传统门诊模式。

Objective To evaluate the application value of hypertension management platform in community hypertension management under the background of Internet+regional medical consortium.Methods A randomized controlled study was conducted to select 594 newly found or confirmed hypertension patients with substandard blood pressure control from the regional medical consortium community hospital affiliated to haidian hospital in Beijing in January 2017 and November 2018.They were randomly divided into intervention group and control group.Routine outpatient guidance and follow-up of the control group;On this basis,the intervention group was included in the remote management platform of medical-conjoined hypertension.The intervention time was one year,and the changes of lifestyle,blood pressure control,blood pressure compliance rate,drug treatment rate and antihypertensive drug compliance before and after the intervention were mainly compared between the two groups.Results A total of 575 patients with hypertension were followed up for one year,291 in the intervention group and 284 in the control group.After 1 year of intervention,the intervention group was significantly better than the control group in terms of enhancing physical exercise and controlling body weight(P<0.05).The systolic and diastolic blood pressure of the two groups were significantly lower than the baseline.Compared between the two groups,the intervention group had significantly lower systolic and diastolic blood pressure reduction rates,blood pressure compliance rate,and drug treatment rate(P<0.05).In terms of drug compliance,compared with the control group,the drug compliance of the intervention group was significantly increased(P=0.02).Conclusion The hypertension management platform under the background of Internet+regional medical consortium has a better prevention and control effect on community hypertension than the traditional outpatient model.