Abstract
BackgroundThe prevalence of hypertension is high and increasing in China in recent years. The treatment and control of hypertension calls for long-term management beyond hospital, which is hard to implement in traditional care settings. Integrated care combined with information technology can promote high-quality healthcare services across the life-course. However, few studies have applied a customized integrated care model in community-based hypertension management in China, catering to the emerging “three-manager” mode. This study aims to identify the effectiveness of a pathway-driven eHealth-based integrated model that implemented as a full-featured telehealth system to facilitate standardized management of hypertension in China.MethodsThe trial has been designed as a 1-year, non-blinded superiority trial with two parallel groups. A total of 402 hypertensive patients who meet the eligibility criteria will be recruited and randomized with a 1:1 allocation. All the participants will receive a mobile device for self-management, which is a part of our telehealth system. Participants in the control group will only use the device for BP measurement and receive regular follow-ups from care providers according to the guidelines. Participants in the intervention group will gain full access to the system and receive intervention based on the proposed model (a well-designed coordinated care pathway consisting of 9 tasks). Outcomes will be measured mainly on three occasions (at inclusion, at 6 months, and at 12 months). The primary outcome is mean change in systolic blood pressure over a 12-month period. Secondary outcomes include changes in diastolic blood pressure, biochemical indexes related to hypertension, lifestyles, self-management adherence, and hypertension awareness, as well as work efficiency of care providers.DiscussionThis study aims to investigate whether a pathway-driven eHealth-based integrated care model based on the “three-manager” mode will improve hypertension control in China. Success of the model would help improve the quality of present community-based management procedures and benefit more patients with uncontrolled hypertension.Trial registrationChinese Clinical Trial Registry ChiCTR1900027645. Registered on November 22, 2019.
Highlights
Background and rationale {6a} Hypertension is a major risk factor for cardiovascular disease and affects more than 20% of the adult population in China, according to the latest national survey [1]
This study aims to investigate whether a pathway-driven eHealth-based integrated care model based on the “three-manager” mode will improve hypertension control in China
Information technology plays a key role in achieving the above goals, which has been described as a complete eHealth-based feedback loop in the eHealth Enhanced Chronic Care Model [15]
Summary
Background and rationale {6a} Hypertension is a major risk factor for cardiovascular disease and affects more than 20% of the adult population in China, according to the latest national survey [1]. In an integrated care setting, health services are delivered by a coordinated multidisciplinary team of providers, aiming to promote the comprehensive delivery of quality services across the life-course [5]. Information technology is essential to implement effective integrated care for hypertensive patients. The treatment and control of hypertension calls for long-term management beyond hospital, which is hard to implement in traditional care settings. Integrated care combined with information technology can promote high-quality healthcare services across the life-course. Few studies have applied a customized integrated care model in community-based hypertension management in China, catering to the emerging “three-manager” mode.
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