目的 探讨移动互联网技术用于社区高血压防控的效果.方法 将556例原发性高血压患者按数字随机法分为2组:移动健康管理组270例,对照组286例.在均继续原药物干预的基础上,移动健康管理组采用移动互联网技术对高血压患者进行实时血压监测,同时通过信息平台自动预警系统语音和短信等及时提醒患者及家属,指导定时服药;对照组无血压实时监测和信息平台预警及提醒通知.随访观察1年,比较两组患者干预前后的血脂、血压情况,采用诺丁汉健康问卷和生活满意度Z量表评定患者的生命质量,比较两组高血压患者管理前后并发症及住院治疗或急诊事件发生率.结果 与管理前比较,管理1年后移动健康管理组血压、血脂明显下降,差异有统计学意义(P<0.05);对照组血压、血脂差异无统计学意义(P>0.05);且管理后移动健康管理组与对照组比较差异有统计学意义(P<0.05).移动健康管理组管理后平均得分为(90.5±3.1)分;较管理前(31.1±5.9)分;明显增高(P<0.001),且与对照组比较差异有统计学意义(P<0.01);对照组管理前后的平均得分比较差异无统计学意义[(30.6±5.3)分比(39.13±4.2)分,P>0.05].移动健康管理组管理后患者生命质量评分为(0.93 ±0.17)分,高于管理前的(0.85 ±0.19)分(P<0.01),并高于对照组(P<0.01);对照组管理前后生命质量评分差异无统计学意义(P>0.05).移动健康管理组管理1年内心脑并发症发生率为1.11%,对照组并发症发生率为6.29%,两组比较差异有统计学意义(P<0.01).移动健康管理组与对照组患者住院治疗或急诊事件发生率分别为0.42、1.65次/(100人·年),差异有统计学意义(P<0.01).移动健康管理组管理后患者依从性由47.78%(129/270)上升到94.44%(255/270),P<0.01;对照组依从性由49.30%(141/286)上升到60.14%(172/286),P>0.05;两组患者治疗依从性比较差异有统计学意义(P<0.叭).管理后移动健康管理组的生活满意度Z量表得分为(9.53 ±3.03)分,明显高于对照组的(8.30±2.96)分(P<0.01).结论 移动健康管理用于社区原发性高血压防控能有效控制患者血压,降低事件发生率,提高患者依从性及生命质量,为原发性高血压防治的新模式.
Objectives To evaluate the effectiveness of mobile internet technology in management of hypertensive patients in community.Methods Total 556 hypertensive patients in community were randomly divided into mobile health management group (management group,n =270) and control group (n =286).Conventional antihypertensive medication was given for both groups.In management group additional mobile health management was performed,including real-time monitoring of blood pressure,reminding of medication by voice reminder and SMS through the information platform of automatic warning system.The blood pressure and blood lipid were measured,quality of life was evaluated by Nottingham Health Profile (NHP) and Life Satisfaction Index Z (LSIZ) scales; the incidence of complications,hospitalization or emergency admission related to hypertension were documented during the 1 year of follow up.Results After 1 year of follow up,the blood pressure and blood lipid decreased significantly (P <0.05) in management group,while no changes in control group (P > 0.05).Score of knowledge related to health education in management group was significantly higher than that of pre-management (90.5 ±3.1 vs.31.1 ±5.9,P <0.001) ; quality of life in management group was higher than that of premanagement (0.93 ±0.17 vs.0.85 ±0.19,P <0.01).During 1 year follow up the complications of heart and brain was 1.11% in management group and 6.29% in control group (P < 0.01).Rates of hospitalization or emergency admission in management group were lower than those in control group (0.42/100 · y vs.1.65/100 · y,P <0.01).After 1 year follow up,compliance of patients in management group increased from 47.78% (129/270) to 94.44% (255/270) (P <0.01),while that in control group increased from 49.30% (141/286) to 60.14% (172/286) (P > 0.05).The scores of life satisfaction degree measured by LSIZ in management group and in control group were 9.53 ± 3.03 and 8.30 ± 2.96,respectively (P < 0.01).Conclusion Mobile Health Management can effectively control blood pressure,reduce incidence of complications,enhance compliance of patients and improve quality of life for hypertensive patients in community.