@文章{信息:doi/10.2196/25630，作者="吴、丹、安、吉叶、于、平、林、惠、马、李、段、惠龙、邓宁"，标题="患者参与高血压管理的模式及电子医疗服务提供者随访对这些模式的影响:聚类分析"，期刊="J医学互联网研究"，年="2021"，月="9"，日="28"，量="23"，数="9"，页数="e25630"，关键词="高血压;保健服务;移动健康;病人参与;电子跟踪;背景:高血压是一种长期的疾病。电子和移动医疗保健服务可以帮助患者自我管理这种情况。然而，并不是所有的管理都是有效的，这可能是由于不同水平的患者参与(PE)与卫生保健服务。医疗保健提供者随访是促进PE和血压(BP)控制的干预措施。目的:本研究旨在通过高血压自我管理app发现和表征PE模式，调查医护人员随访对PE的影响，并确定每种PE模式下随访对血压的影响。 Methods: PE was represented as the number of days that a patient recorded self-measured BP per week. The study period was the first 4 weeks for a patient to engage in the hypertension management service. K-means algorithm was used to group patients by PE. There was compliance follow-up, regular follow-up, and abnormal follow-up in management. The follow-up effect was calculated by the change in PE (CPE) and the change in systolic blood pressure (CSBP, SBP) before and after each follow-up. Chi-square tests and z scores were used to ascertain the distribution of gender, age, education level, SBP, and the number of follow-ups in each cluster. The follow-up effect was identified by analysis of variances. Once a significant effect was detected, Bonferroni multiple comparisons were further conducted to identify the difference between 2 clusters. Results: Patients were grouped into 4 clusters according to PE: (1) PE started low and dropped even lower (PELL), (2) PE started high and remained high (PEHH), (3) PE started high and dropped to low (PEHL), and (4) PE started low and rose to high (PELH). Significantly more patients over 60 years old were found in the PEHH cluster (P≤.05). Abnormal follow-up was significantly less frequent (P≤.05) in the PELL cluster. Compliance follow-up and regular follow-up can improve PE. In the clusters of PEHH and PELH, the improvement in PE in the first 3 weeks and the decrease in SBP in all 4 weeks were significant after follow-up. The SBP of the clusters of PELL and PELH decreased more (--6.1 mmHg and --8.4 mmHg) after follow-up in the first week. Conclusions: Four distinct PE patterns were identified for patients engaging in the hypertension self-management app. Patients aged over 60 years had higher PE in terms of recording self-measured BP using the app. Once SBP reduced, patients with low PE tended to stop using the app, and a continued decline in PE occurred simultaneously with the increase in SBP. The duration and depth of the effect of health care provider follow-up were more significant in patients with high or increased engagement after follow-up. ", issn="1438-8871", doi="10.2196/25630", url="//www.mybigtv.com/2021/9/e25630", url="https://doi.org/10.2196/25630", url="http://www.ncbi.nlm.nih.gov/pubmed/34581680" }