Effectiveness of Hypertensive Treatment in Health Promoting Hospital and Community Medical Unit

Rudklao Rerkrujipimol, M.D. Family Physician, Social Medicine Division Khon Kaen Hospital, Khon Kaen Province.

Abstract

Background: Hypertension has serious health consequences, with one in three individuals worldwide suffering from high blood pressure. This condition leads to stroke, heart attack, heart failure, kidney failure, and other health problems. In Khon Kaen district, hypertensive care is provided to patients at Community Medical Units (CMU) by Family Medicine doctors and at Health Promoting Hospitals (HPH) by Family Medicine doctors in collaboration with professional nurses. However, However, there has been no comparative study on the effectiveness of hypertension treatment between these two types of care models. The researcher is interested in conducting this study to further develop and improve the service models.

Objective: To evaluate the effectiveness of controlling Systolic Blood Pressure (SBP) over a 12-month period in hypertensive patients treated at HPH and CMU.

Methods: This study is a retrospective cohort study that collected data from patient medical records in the JHCIS database for hypertensive patients from October 1, 2022, to January 31, 2024. The study included two groups: 143 patients treated at HPH and 143 patients treated at CMU. The data were analyzed using descriptive statistics, including percentages, means, medians, and inferential statistics to compare differences using Fisher’s exact test, Mantel-Haenszel Chi-square test, and Mann-Whitney U test.

Results: The mean changes in SBP, DBP, BMI, and waist circumference between the two groups were not significantly different. However, changes in eGFR were significantly different. Laboratory tests for hypertensive patients, including serum creatinine, LDL, fasting plasma glucose, and urine albumin, were thoroughly conducted. The testing of serum potassium in patients on ACEIs, ARBs, and HCTZ, as well as serum uric acid testing in patients on HCTZ, and the median duration of annual laboratory testing between the two study groups, showed statistically significant differences.

Conclusion: The study found no significant difference in SBP changes over 12 months between the two care models. Both groups completed general laboratory tests for hypertensive patients thoroughly. However, the testing for serum potassium, uric acid, and annual testing duration showed significant statistical differences. Thus, the current care models can continue, but improvements in service standards should be made for better patient care.