Антон Киселев » Публикация

Аннотация Purpose: To determine the effect of a computer system using text messages (SMS) for patient feedback on the control of blood pressure (BP) in patients with arterial hypertension (AH). Methods: 199 patients (≥ 18 years old) with established AH were enrolled in the study. 97 of them (mean age 49 ± 11.3 years) were offered to answer to automatically generated SMS requests about their BP level during 1 year. The other 102 patients (mean age 51 ± 11.1 years) received usual care. Their BP records concerning the same period were extracted from ambulatory patients’ cards retrospectively. Three control check points were assigned for the group of SMS monitoring - one, six and 12 months of follow up. The number of patients dropped out of SMS monitoring, and principal causes of withdrawal were determined on every checkpoint. A part of patients with goal BP was estimated over each period. Goal BP was defined according to ESH-ESC Hypertension Guidelines (2007). In a year of follow up, the rate of the goal BP achievement was compared in SMS monitoring group vs. the group of usual care. Results: 62 from 97 patients included in the group of SMS monitoring (64%) successfully completed one year of follow up. During the first month 15 patients (16%) had left the study. The principal cause in 9 patients (60%, p < 0.05) was “difficulties using text messaging”. During the period from one to six months of observation 19 more patients had withdrawn from SMS monitoring. The main cause in 15 participants (79%, p < 0.05) was “lost of interest”. Patients reported they felt well and were satisfied with treatment. During the period from six to 12 months only 1 patient had withdrawn (the cause – “lost of interest”). In the group of SMS monitoring goal BP was achieved in 84% of patients (CI 75% - 93%) after the first month of study, in 77% (CI 67% - 88%) after six months and in 71% (CI 60% - 83%) after 12 months. In the group of usual care goal BP was achieved in only 12% of patients (CI 5% – 18%). Odds ratio was 13 (CI 6.0-29.6). Conclusion: Use of computer system with patient feedback via text messages enhances achievement of goal BP in AH patients as compared with usual care, and facilitates its maintenance in primary care over a long time period.