Personalized information support for hypertension management: an open-label cluster randomized controlled trial in rural Anhui, China

IF 7.6 1区医学 Q1 HEALTH CARE SCIENCES & SERVICES

The Lancet Regional Health: Western Pacific Pub Date : 2025-06-01 DOI:10.1016/j.lanwpc.2025.101588

Xingrong Shen , Ruirui Cui , Nana Li , Xin Yang , Tongqing Xu , Shumin Zeng , Xuanhe Liu , Yuning Wang , Ying Li , Dongying Xiao , Xuewu Zhang , Rong Liu , Tingting Zhang , Xiyan Kong , Jing Chai , Dongxiao Gu , Debin Wang

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引用次数: 0

Abstract

Background

Lack of personalized hypertension management (PHM) is the main driver of low treatment and control rates of blood pressure (BP). Digital intervention has great potential in realizing PHM.

Methods

This two-arm cluster randomized controlled trial aimed at assessing the added value of personalized information for leveraging commonly recognized objective behaviors facilitated by pragmatic digital applications. Implemented in Jieshou of Anhui Province, China, the intervention lasted for 12 months starting from August 2021. The primary outcome measure was systolic BP (SBP); and the secondary measures, diastolic BP (DBP), BP control rate, quality adjusted of life years (QALYs), deaths of and admissions for all-causes and hypertension complications and behavior scores. These measures were analyzed using mainly generalized linear mixed modeling controlled for clustering with or without imputation.

Findings

The trial recruited 2392 patients at a response rate of 96.84%. At 12-month follow-up, the intervention group demonstrated (via intent-to treat analysis) superior SBP, −5.60 mmHg (95% CI: −8.10, −3.09; p < 0.001). Compared with 24-months follow-up, the adjusted difference decreased moderately to −3.93 mmHg (95% CI: −5.80, −2.05; p < 0.001). The intervention arm demonstrated non-greater risks of all the adverse effects observed.

Interpretation

The study provides evidence to support the use of the personalized information support in controlling hypertension and its complications. The next step is an implementation strategy to incorporate the intervention into daily practice and realize its benefits.

Funding

The trial was supported by National Natural Science Foundation of China (No. 72004002) and Scientific Research Foundation of Education Department of Anhui Province of China (No. KJ2021A0259).

查看原文本刊更多论文

高血压管理的个性化信息支持：中国安徽农村的一项开放标签集群随机对照试验

背景：缺乏个性化的高血压管理（PHM）是血压（BP）治疗和控制率低的主要原因。数字干预在实现PHM方面具有很大的潜力。方法本双组随机对照试验旨在评估个性化信息的附加价值，以利用实用的数字应用程序促进普遍认可的客观行为。该干预措施在中国安徽省揭寿市实施，自2021年8月起持续12个月。主要结局指标为收缩压（SBP）；次要指标为舒张压（DBP）、血压控制率、生命质量调整年（QALYs）、全因死亡和入院人数、高血压并发症和行为评分。对这些度量进行了分析，主要采用广义线性混合模型控制聚类，有或没有输入。研究结果：该试验招募了2392名患者，有效率为96.84%。在12个月的随访中，干预组（通过意向治疗分析）表现出更好的收缩压，- 5.60 mmHg (95% CI: - 8.10, - 3.09；p & lt;0.001)。与24个月的随访相比，调整后的差异中度下降至- 3.93 mmHg (95% CI: - 5.80, - 2.05；p & lt;0.001)。干预组显示观察到的所有不良反应的风险都没有增加。本研究为个性化信息支持在高血压及其并发症控制中的应用提供了证据支持。下一步是将干预纳入日常实践并实现其效益的实施策略。国家自然科学基金项目（No. 72004002）和安徽省教育厅科研基金项目（No. 72004002）资助。KJ2021A0259)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health

CiteScore

8.80

自引率

2.80%

发文量

305

审稿时长

11 weeks

期刊介绍： The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.