基于“高血压达标中心”管理模式下高血压患者的治疗效果研究

Effects of Hypertension Center-Based Management on Blood Pressure in Hypertension Patients

摘要: 目的：探讨基于“高血压达标中心”管理模式(简称“达标中心”模式)对高血压患者的血压控制效果、用药依从性及生活质量的影响。方法：选取2019年4月~2019年12月期间就诊于青岛大学附属心血管病医院高血压达标中心的307例高血压患者作为试验组，同期未加入“达标中心”管理模式的267例高血压患者作为对照组，进行前瞻性研究。试验组按照“达标中心”模式及流程进行管理，对照组按医院门诊常规诊疗处理；根据两组患者的病情每1~3个月随访1次，共随访6个月，比较两组患者经不同管理模式前后的血压控制效果、用药依从性评价(MMAS-8)、生活质量自评表(SF-36)、抑郁评价(PHQ-9)和焦虑评价(GAD-7)。结果：管理6个月后，试验组血压控制率较对照组高(90.55%比53.93%，P < 0.05),试验组收缩压下降值较对照组高[(28.90 ± 16.17) mmHg比(22.20 ± 19.12) mmHg，P < 0.05]；两组患者用药依从性均高于管理前，且试验组高于对照组(P < 0.05)；两组患者SF-36评分表中除躯体疼痛无统计学差异外，余7项条目在试验组评分更高且具有统计学差异(P < 0.05)；两组患者在管理后抑郁、焦虑评分均有所下降，但试验组下降更加明显(P < 0.05)。多元线性回归分析示，“达标中心”模式与收缩压变化显著相关，相关系数为−5.8 (P < 0.05)。结论：“达标中心”模式对高血压病人血压控制效果明显，有效的提高患者的用药依从性，改善患者的生活质量。

Abstract: Objective: To explore the influence of the management model based on “Hypertension Center” (referred to as “center” management model) on blood pressure control effect, medication adherence, and quality of life in hypertension patients. Methods: Selected 307 hypertensive patients who were in the Hypertension Center of the Cardiovascular Hospital of Qingdao University from April 2019 to December 2019 as the experimental group, and 267 hypertensive patients who did not join the “center” management model during the same period were selected as controls group. And this study conducted a prospective study on the above patients. The test group was managed in accordance with the “center” management model and process, and the control group was treated according to the routine diagnosis and treatment of the hospital; according to the condition of the two groups of patients, the patients were followed up every 1~3 months for a total of 6 months. This study compared the blood pressure control effect, medication adherence evaluation (MMAS-8), quality of life self-assessment form (SF-36), depression evaluation (PHQ-9) and anxiety evaluation (GAD-7). Results: After 6 months of management, the blood pressure control rate of the test group was higher than that of the control group (90.55% vs. 53.93%, P < 0.05), and the drop of the systolic blood pressure in the test group was higher than that of the control group [(28.90 ± 16.17) mmHg vs. (22.20 ± 19.12) mmHg, P < 0.05]. The medication adherence of the two groups of patients was higher than before the management, and the experimental group was higher than the control group (P < 0.05). Except for no statistical difference in body pain in the SF-36 score of the two groups of patients, the remaining 7 items in the test group scored higher and had statistical differences (P < 0.05). The depression and anxiety scores of the two groups of patients decreased after management, but the decline in the experimental group was more significant (P < 0.05). Multivariate linear regression analysis showed that the “center” management model was significantly related to changes in systolic blood pressure, with a correlation coefficient of −5.8 (P < 0.05). Conclusion: The “center” management model has a significant effect on blood pressure control in hypertensive patients. It can effectively improve the patient’s medication adherence and improve the patient’s quality of life.