A Clinical Prediction Model of Medication Adherence in Hypertensive Patients in a Chinese Community Hospital in Beijing.

BACKGROUND: Hypertension remains a global health problem. Since, there is a significant positive correlation between antihypertensive medication adherence and blood pressure control, it is therefore of great importance to elucidate the determinants of adherence to antihypertensive medications among hypertensive patients. METHODS: Hereby, we retrospectively analyzed the medical records of a hypertensive cohort recruited from a community hospital in Beijing, China, to investigate the factors affecting adherence to antihypertensive medications using decision trees. In addition, all data were assigned into a training set (75%) and testing set (25%) by the random number seed method to build and validate a compliance predictive model. We identified that how many times patients became nonadherent to antihypertensive medications in the year before the first prescription, types of antihypertensive drugs used in the year before the first prescription, body weight, smoking history, total number of hospital visits in the past year, total number of days of medication use in the year before enrollment, age, total number of outpatient follow-ups in the year after the first prescription, and concurrent diabetes greatly affected the compliance to antihypertensive medications. RESULTS: The compliance predictive model we built showed a 0.78 sensitivity and 0.69 specificity for the prediction of the compliance to antihypertensive medications, with an area under the representative operating characteristics curve of 0.810. CONCLUSIONS: Our data provide new insights into the improvements of the compliance to antihypertensive medications, which is beneficial for the management of hypertension, and the compliance predictive model may be used in community-based hypertension management.

Effect of an intelligent family physician-optimised coordination model program on hypertension management in a Beijing community.

The prevalence of hypertension in China is increasing. To control chronic diseases, the Beijing Municipal Government implemented an intelligent family physician-optimised collaborative model (IFOCM). The present retrospective study assessed the effectiveness of the IFOCM in the management of hypertensive patients at the Fangzhuang Community Health Service Centre, Beijing. Using deidentified data from hypertensive patients, blood pressure (BP), BP control rate, 10-year risks of ASCVD, lifestyle changes and blood lipid levels were compared before and after implementation of the IFOCM. In all, 7332 patients with hypertension were included in the study. Systolic BP decreased from 144.59 to 142.96mmHg after program implementation (P<0.001), and the overall BP control rate increased from 41.43% to 46.49% (P<0.001). The proportion of patients predicted to be at a high 10-year risk of developing atherosclerotic cardiovascular disease decreased from 77.27% to 64.61% (P<0.001). After program implementation, body mass index decreased (from 24.87 to 24.36kg/m2; P<0.001), exercise frequency and intensity increased and salt intake, cigarette smoking, total cholesterol and low-density lipoprotein cholesterol all decreased significantly (P<0.001). The IFOCM program is effective in managing hypertension and providing timely patient care.