Factors Associated With Physician Recommendation of Home Blood Pressure Monitoring and Blood Pressure in the US Population
Factors Associated With Physician Recommendation of Home Blood Pressure Monitoring and Blood Pressure in the US Population
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DOI：
10.1093/ajh/hpaa093
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发表时间：
2020-09-01
影响因子：
3.2
通讯作者：
Juraschek, Stephen P.
中科院分区：
文献类型：
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作者：
Tang, Olive;Foti, Kathryn;Juraschek, Stephen P.
背景高血压指南推荐家庭血压监测(HBPM)以帮助实现血压(BP)控制。我们假设，根据医生的建议使用HBPM将与较低的血压和更高的药物依从性相关。方法我们使用2009-2014年国家健康和营养检查调查中6,320名患有高血压的成年人的数据来表征(I)提供者对HBPM的推荐和(Ii)HBPM使用对两个结果的关联：测量的BP(线性回归)和用药依从性(Logistic回归)。结果在患有高血压的成年人中，30.1%的人报告了医生推荐HBPM的情况，其中82.0%的人报告使用了HBPM。在那些没有报告HBPM的医生建议的人中，28.3%的人使用HBPM。与医生推荐相关的因素包括医疗保险、高等教育程度、高血压意识以及有抗高血压药物的处方。在那些报告收到医生建议的人中，使用HBPM的人的平均血压比没有使用HBPM的人低3.1/4.5毫米汞。那些报告有医生建议并使用HBPM的人更有可能报告高血压用药依从性(优势比2.9；95%可信区间：2.0，4.4)。结论SHBPM的使用与较低的血压和较高的用药依从性相关。在那些有医生建议的人中，HBPM的使用率更高。这些结果支持医生在使用HBPM进行BP管理方面的咨询和与患者合作方面的作用。
BACKGROUNDHypertension guidelines recommend home blood pressure monitoring (HBPM) to help achieve blood pressure (BP) control. We hypothesized that HBPM use with a physician recommendation would be associated with lower BP and greater medication adherence.METHODSWe used data from 6,320 adults with hypertension in the National Health and Nutrition Examination Survey 2009-2014 to characterize the association of (i) provider recommendation for HBPM and (ii) HBPM use on 2 outcomes: measured BP (linear regression) and medication adherence (logistic regression). Provider recommendation, HBPM use, and medication use were self-reported.RESULTSAmong adults with hypertension, 30.1% reported a physician recommendation for HBPM, among whom 82.0% reported using HBPM. Among those who did not report a physician recommendation for HBPM, 28.3% used HBPM. Factors associated with a physician recommendation were having health insurance, higher education attainment, hypertension awareness, and having a prescription for antihypertensive medication. Among those who reported receiving a physician recommendation, those who used HBPM had a mean BP that was 3.1/4.5 mm Hg lower than those who did not. Those who reported having a physician recommendation and using HBPM were more likely to report hypertension medication adherence (odds ratio 2.9; 95% confidence interval: 2.0, 4.4).CONCLUSIONSHBPM use was associated with lower BP and higher medication adherence. Use of HBPM was higher among those with a physician recommendation. These results support a role for physicians in counseling and partnering with patients on HBPM use for BP management.