Günlük İlaç Hatırlatıcı Kısa Mesaj (SMS) Göndermenin Hipertansif Hastalarda Kan Basıncı Kontrolü ve İlaç Uyumu Üzerine Etkisi

Year 2017, , 136 - 141, 06.07.2017

Ferhat Ekinci Bilge Tuncel , Demet Merder Coşkun , Mehmet Akman , Arzu Uzuner

https://doi.org/10.18521/ktd.288633

Cited By: 1

Abstract

GİRİŞ:  Dünya Sağlık Örgütü(DSÖ)
verilerine göre hipertansiyon, diyabet ve dislipidemi gibi kronik hastalıklarda
uzun süreli medikal tedaviye uyumsuzluk bireylerin sağlığını ve ekonomik
koşullarını ciddi dereced etkilemektedir. Antihipertansif ilaçların ortalama
kullanım oranı %64’tür. Bu çalışmanın amacı günlük kısa mesaj(sms) göndermenin
hipertansif hastalarda kan basıncı kontrolü ve ilaç uyumu üzerine etkisini
değerlendirmektir.

YÖNTEM: Bu araştırma randomize kontrollü bir araştırmadır.
Çalışmaya Marmara Üniversitesi Aile Hekimliği Polikliniğine başvuran ve
hipertansif olduğu bilinen hastalar dahil edilmiştir. Katılımcılar randomizasyonla
kontrol ve müdahale (sms) grubu olmak üzere iki gruba ayrılmıştır. Kontrol
grubuna sadec rutin sağlık hizmeti verilmiş, müdahale grubuna buna ek olarak
iki ay boyunca günlük hatırlatma mesajı yollanmıştır. Katılımcılardan ilk vizit
ve son vizit öncesi bir haftalık kan basıncı(KB) takibi yapmaları istenmiştir
ve her görüşmede KB ölçümleri yapılmıştır. İlaç uyumu Modifiye Morisky Ölçeği
ile değerlendirilmiştir. Grupların KB ölçümleri ve ilaç uyumları
karşılaştırılmıştır.

BULGULAR: İçerleme kriterlerini karşılayan 60 katılımcı
çalışmaya dahil edildi. Katılımcıların 45’i kadın, 15’i erkekti. Katılımcıların
yaş ortalaması 55±11; ortalama Beden kitle
İndeksi (BMI)  30±5; günlük kullandıkları
tablet sayısı ortalaması 4±2 idi. Her iki grubun ilk vizitteki KB ölçüm
ortalamları ile ilk görüşme bir haftalık evde KB ölçüm ortalamaları birbirine
benzer olarak bulundu.(p>0,05) Buna karşılık müdahale grubunun hem son
vizitteki KB ölçüm ortalaması, hem de ikinci görüşme evde bir haftalık KB takip
ölçüm ortalaması kontrol grubuna göre istatistiksel olarak anlamlı derecede
düşük bulundu.(p<0,05) Ayrıca müdahale grubunun ilk-son visit KB ölçüm
değişim ortalaması ile ilk-son görüşme bir haftalık KB ölçüm takibi değişimi
ortalaması kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksek
bulundu.(p<0,05) Kontrol grubunun ilaç uyumu %36,7 iken, müdahale grubunun
ilaç uyumu %96,7 olarak bulundu.

SONUÇ: Günlük ilaç hatırlatıcı kısa mesaj göndermek, hipertansiyon
hastalarında kan basıncı kontrolünü sağlama ve ilaç uyumunu arttırmada
etkilidir.

Keywords

Uyum, antihipertansif, kısa mesaj, kan basıncı, hipertansiyon

Effects on Blood Pressure Control and Compliance For Medical Treatment in Hypertensive Patients By Sending Daily SMS as a Reminder

Abstract

BACKGROUND: According to the World Health Organization non-compliance
in long term medical treatments such as hypertension, diabetes and dyslipidemia
causes serious problems on patients health and general economic benefits. The
average compliance ratio for using antihypertensive medications is 64%. The aim
of this study is determine the effects on blood pressure control and compliance
for medical treatment in hypertensive patients by sending daily `sms`.

METHOD: This is a randomized controlled study. Participants were
selected among hypertensive patients of Marmara University department of family
medicine outpatient clinics and randomized into sms and non-sms groups. While
everyday an sms has been send to the patients in the sms group for two months, there
was no intervention for the control group except routine care. One week
ambulatory blood pressure measurements have been requested twice of all the
patients. Blood pressure measurements were done at the first and the last visit.
Medicine compliance was scaled by using Modified Morrisky Questionnaire. Blood
pressure measurements and compliance for medical treatment of each group was
compared.

RESULTS: A total of sixty patients who fulfilled the inclusion criteria
were enrolled in the study:45 were female,15 male; mean age was 55±11; mean BMI
was 30±5; mean number of tablets per day was 4±2. There was statistically
significant difference between the first and the last visit measurements for
SBP and DBP for the intervention group (p=0.051 for SBP, p=0.057 for DBP). No
statistically significant difference has been determined in the control group.
In intervention group one week ambulatory BP measurements averages differed
between the first visit and the last visit (SBP 145±8mmHg/DBP 82±6mmHg; SBP
131±7mmHg/DBP 73±7mmHg; p < 0.001). Medicine compliance ratio was 36,7% for
the control group, 96,7% for the intervention group.

CONCLUSION: Reminding taking antihypertensive treatment with daily sms
is an effective method to control blood pressure and and to raise compliance in
hypertensive patients. 

Keywords

Compliance, antihypertensive, sms, blood pressure, hypertension

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