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    Please use this identifier to cite or link to this item: http://tkuir.lib.tku.edu.tw:8080/dspace/handle/987654321/118074


    Title: A Web-Based Self-Titration Program to Control Blood Pressure in Patients With Primary Hypertension: Randomized Controlled Trial
    Authors: Kao, Chi-Wen;Chen, Ting-Yu;Cheng, Shu-Meng;Lin, Wei-Shiang;Chang, Yue-Cune
    Keywords: Web-based;self-titration;blood pressure;hypertension;health-related quality of life
    Date: 2019-12
    Issue Date: 2020-02-12 12:10:20 (UTC+8)
    Abstract: Background: Hypertension is a major cause of mortality in cardiac, vascular, and renal disease. Effective control of elevated
    blood pressure has been shown to reduce target organ damage. A Web-based self-titration program may empower patients to
    control their own disease, share decisions about antihypertensive dose titration, and improve self-management, ultimately improving
    health-related quality of life.
    Objective: Our primary aim was to evaluate the effects of a Web-based self-titration program for improving blood pressure
    control in patients with primary hypertension. Our secondary aim was to evaluate the effects of that program on improving
    health-related quality of life.
    Methods: This was a parallel-group, double-blind, randomized controlled trial with assessments at baseline, 3 months, and 6
    months. We included patients with primary hypertension (blood pressure>130/80 mm Hg) from a cardiology outpatient department
    in northern Taiwan and divided them randomly into intervention and control groups. The intervention group received the Web-based
    self-titration program, while the control group received usual care. The random allocation was concealed from participants and
    outcome evaluators. Health-related quality of life was measured by the EuroQol five-dimension self-report questionnaire. We
    used generalized estimating equations to evaluate the effects of the intervention.
    Results: We included 222 patients and divided them equally into intervention (n=111) and control (n=111) groups. Patients
    receiving the Web-based self-titration program showed significantly greater improvement in the systolic and diastolic blood
    pressure control than those who did not receive this program, at 3 months (–21.4 mm Hg and –5.4 mm Hg, respectively; P<.001)
    and 6 months (–27.8 mm Hg and –9.7 mm Hg, respectively; P<.001). Compared with the control group, the intervention group
    showed a significant decrease in the overall defined daily dose at both 3 (–0.202, P=.003) and 6 (–0.236, P=.001) months. Finally,
    health-related quality of life improved significantly in the intervention group compared with the control group at both 3 and 6
    months (both, P<.001).
    Conclusions: A Web-based self-titration program can provide immediate feedback to patients about how to control their blood
    pressure and manage their disease at home. This program not only decreases mean blood pressure but also increases health-related
    quality of life in patients with primary hypertension.
    Relation: Journal of Medical Internet Research 21 (12), e15836
    DOI: 10.2196/15836
    Appears in Collections:[Graduate Institute & Department of Mathematics] Journal Article

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