Objective: To explore the effect of remote "Internet+" interactive management strategy on blood pressure control in patients with hypertension during normalized epidemic prevention and control of COVID-19. Methods: This is a randomized controlled study. A total of 394 patients with hypertension who were treated in Chinese People's Liberation Army General Hospital from October 2019 to December 2020 were randomly divided into experimental group (197 cases) and control group (197 cases). The experimental group adopted remote "Internet+" interaction mode to carry out remote blood pressure intervention, and the control group received traditional blood pressure control mode, and the intervention time was 6 months. Evaluation indicators included blood pressure level, blood pressure lowering speed, time to target blood pressure, blood pressure measurement times, communication times with doctors, medication compliance, blood pressure measurement compliance and disease awareness after 6 months of intervention. The evaluation indexes of the two groups were compared, and the bivariate Pearson correlation analysis was used to explore the relationship between the speed of blood pressure reduction and the times of blood pressure measurement and doctor communication in all patients. Results: A total of 394 patients with hypertension were included in this study, including 209 males, aged (67.6±2.8) years old. After 6 months of intervention, the systolic and diastolic blood pressure of the two groups were both lower than the baseline blood pressure before intervention (both P<0.05), the systolic blood pressure ((125.7±11.7) mmHg (1 mmHg=0.133 kPa) vs. (132.6±12.9) mmHg, P<0.001) and diastolic blood pressure ((72.4±10.7) mmHg vs. (79.8±11.6) mmHg, P<0.001) in the experimental group were lower than those in the control group. The blood pressure reduction speed of the experimental group was faster than that of the control group ((18.63±1.59) mmHg/d vs. (13.26±2.85) mmHg/d, P<0.001), and the time to reach the target blood pressure in the experimental group was shorter than that in the control group ((23.69±2.93) d vs. (47.12±5.81) d, P<0.001). Compared with the control group, the blood pressure measurement times ((0.98±0.13) times/d vs. (0.20±0.40) times/d, P<0.05) and the number of communications with doctors ((0.97±0.16) times/week vs. (0.12±0.32) times/week, P<0.05) were significantly higher in the experimental group. Correlation analysis showed that the speed of blood pressure reduction was positively correlated with the number of blood pressure measurements (r=0.419, P<0.01) and the number of communications with doctors (r=0.857, P<0.01). The proportion of standardized medication (93.91% (185/197) vs. 51.78% (102/197), P<0.001), timely measurement (97.46% (192/197) vs. 47.21% (93/197), P<0.001) and high-degree disease awareness (94.42% (186/197) vs. 49.24% (97/197), P<0.001) were significantly higher in the experimental group than those in the control group. Conclusions: The remote "Internet+" interactive management strategy can effectively improve patients' blood pressure control. The doctor-patient interaction can improve medication compliance and measurement compliance of patients, and help shorten the time to reach the target blood pressure.
目的： 探讨远程“互联网+”交互管理模式对高血压患者血压控制情况的影响。 方法： 本研究为随机对照研究。选择2019年10月至2020年12月于解放军总医院接受治疗的394例高血压患者作为研究对象，随机分为对照组（197例）与试验组（197例）。试验组采取远程“互联网+”交互管理模式进行血压干预，对照组采用普通血压监控模式，干预时间为6个月。评价指标包括干预后6个月患者的血压水平、降压速度、血压达标时间、血压测量次数、与医生沟通次数、药物依从性、血压测量依从性及疾病认知程度。比较两组患者的各项评价指标，并采用双变量Pearson相关性分析在全部患者中探讨降压速度与血压测量次数、医生沟通次数之间的关系。 结果： 本研究共纳入394例高血压患者，其中男性209例，年龄（67.6±2.8）岁。两组患者干预后收缩压及舒张压均低于干预前的基线血压（P均<0.05）；干预后6个月试验组收缩压［（125.7±11.7）mmHg（1 mmHg=0.133 kPa）比（132.6±12.9）mmHg，P<0.001］及舒张压［（72.4±10.7）mmHg比（79.8±11.6）mmHg，P<0.001］均低于对照组。试验组降压速度快于对照组［（18.63±1.59）mmHg/d比（13.26±2.85）mmHg/d，P<0.001］，血压达标时间短于对照组［（23.69±2.93）d比（47.12±5.81）d，P<0.001］。与对照组比较，试验组的血压测量次数［（0.98±0.13）次/d比（0.20±0.40）次/d，P<0.05］及与医生沟通次数［（0.97±0.16）次/周比（0.12±0.32）次/周，P<0.05］更多。相关性分析发现，降压速度与血压测量次数（r=0.419，P<0.01）及与医生沟通次数（r=0.857，P<0.01）呈正相关。试验组中规范用药［93.91%（185/197）比51.78%（102/197），P<0.001］、按时测量［97.46%（192/197）比47.21%（93/197），P<0.001］、疾病认知度高者占比［94.42%（186/197）比49.24%（97/197），P<0.001］均高于对照组。 结论： 远程“互联网+”交互管理模式可有效改善患者血压情况，通过医患互动可提高患者用药依从性和测量依从性，有助于缩短血压达标时间。.