HumanInsight EFFECT OF A WEB-BASED MANAGEMENT PLATFORM ON HYPERTENSION CONTROL IN COMMUNITY: A RANDOMIZED CLINICAL TRIAL
J Hypertens. 2022 Jun 1;40(Suppl 1):e31. doi: 10.1097/01.hjh.0000835548.09751.c8.
OBJECTIVE: To assess the effect of multi-component intervention delivered by a web-based platform on improving blood pressure control rate.
DESIGN AND METHOD: A cluster andomised clinical trial of a hypertension management program was conducted from January 1 to December 31, 2018 in 66 communities. Communities were andomised to either the intervention group (usual care combined with multi-component intervention delivered by a web-based platform) or control group (usual care only). The intervention included health education, lifestyle modification, self-monitoring and treatment. In order to support the implementation of intervention program, a web based-platform was established. Automated classification and personalized follow-up schedule would be generated by prespecified algorithm according to the patients' information. The primary outcome was the change in blood pressure control rate from baseline to 12 months among hypertension patients in the intervention and control group. The secondary outcomes were the changes in blood pressure and lifestyle factors.
RESULTS: A total of 3,872 participants (2,994 in the intervention group and 878 in control group) were included in the analysis. Blood pressure control rate at baseline was 31.4% in the intervention group and 30.2% in the control group. After 12 months of the intervention, the blood pressure control rate for the intervention group compared with the control group was significantly higher (65.9% vs 42.0%; odds ratio, 1.25; 95%CI,1.19-1.32; P < 0.001). The intervention effect on systolic blood pressure was -8.0 mmHg (95%CI, -9.8 to -6.2 mmHg; P < 0.001) and on diastolic blood pressure was -1.7 mmHg (95%CI, -2.8 to -0.6 mmHg, P = 0.003). The blood pressure control rate showed a gradual increment throughout the whole intervention duration. What's more, greater improvement was observed in the proportion of regular exercise (17.8%; 95%CI, 15.3%-20.3%; P < 0.001).
CONCLUSIONS: This trial found that a multi-component intervention delivered by a web-based platform appeared to be more effective than usual care, leading to measurable benefits such as lower blood pressure, improved hypertension control, and adoption of healthy lifestyle habits. Telemedicine may be a better way to manage hypertension patients in community.
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