Automedida da pressão arterial para o controle das cifras tensionais e para a adesão ao tratamento

Souza, Weimar Kunz Sebba Barroso de; Jardim, Paulo César Brandão Veiga; Brito, Ludmila Porto; Araújo, Fabrício Alves; Sousa, Ana Luíza Lima

doi:10.1590/s0066-782x2012005000010

Cited by 14 publications

(2 citation statements)

References 18 publications

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“…A automedida da pressão arterial torna-se ferramenta importante para contribuir no diagnóstico, acompanhamento e no tratamento de pacientes hipertensos. Sugere-se um número mínimo de sete medidas e valores de normalidade iguais ou abaixo de 130/80 mmHg (Barroso et al, 2021;Souza et al, 2012) Evidências suportam a ideia de que o valor prognóstico da AMPA é igual ou superior ao da pressão arterial do consultório (PAC). A AMPA está mais associada ao risco de mortalidade cardiovascular que a PAC em alguns estudos populacionais (Ohkubo et al, 1998;Sega et al, 2005;Mancia et al, 2006).…”

Section: Discussionunclassified

Manual educativo para automedida da pressão arterial no controle de pacientes hipertensos cardiopatas

Costa

Girão

Riello

et al. 2023

RSD

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A hipertensão arterial (HA) é definida como a elevação crônica da pressão arterial (PA) acima de 139/89 mmHg em adultos. É uma condição frequentemente assintomática e costuma evoluir com alterações estruturais e ou funcionais em órgãos como o coração, sendo o principal fator reversível para as doenças cardiovasculares. O objetivo do presente estudo foi desenvolver um manual educativo como facilitador da automedida da pressão arterial (AMPA) no controle de pacientes hipertensos cardiopatas. Participaram da pesquisa 37 pacientes hipertensos e cardiopatas atendidos no Centro Integrado de Diabetes e Hipertensão de Fortaleza. Todos fizeram uso do manual e posteriormente foi avaliada a usabilidade através da System Usability Scale (SUS), traduzida para o português como Escala de Usabilidade do Sistema, fundamentada no grau de concordância conforme escala Likert. A aceitabilidade do manual foi mensurada através do Technology Acceptance Model (TAM) originalmente formulado por Davis. Em relação ao questionário de usabilidade com a escala SUS, a média obtida do escore total foi de 78,78±11,66 sendo a usabilidade considerada excelente, assim como a aceitabilidade que obteve um escore final de 96,08 ± 5,67. Pode-se concluir que o manual demonstrou excelente usabilidade e aceitabilidade por parte dos investigados o que comprova a sua importância para controle da pressão arterial, possuindo características favoráveis para ser uma ferramenta voltada para auxiliar o paciente no melhor conhecimento da sua patologia e a correta forma de aferir a pressão arterial.

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Section: Discussionunclassified

Manual educativo para automedida da pressão arterial no controle de pacientes hipertensos cardiopatas

Costa

Girão

Riello

et al. 2023

RSD

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“…Several studies have reported low rates of adherence to RM [9-11]. Adherence refers to the extent to which a patient follows a prespecified treatment regimen or protocol [12]. The methods used to measure treatment adherence are either direct or indirect.…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Adherence to Remote Monitoring and Patient Characteristics: Observational Study in Women With Pregnancy-Induced Hypertension

Vandenberk¹,

Lanssens²,

Storms³

et al. 2019

JMIR Mhealth Uhealth

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Background Pregnancy-induced hypertension (PIH) is associated with high levels of morbidity and mortality in mothers, fetuses, and newborns. New technologies, such as remote monitoring (RM), were introduced in 2015 into the care of patients at risk of PIH in Ziekenhuis Oost-Limburg (Genk, Belgium) to improve both maternal and neonatal outcomes. In developing new strategies for obstetric care in pregnant women, including RM, it is important to understand the psychosocial characteristics associated with adherence to RM to optimize care. Objective The aim of this study was to explore the role of patients’ psychosocial characteristics (severity of depression or anxiety, cognitive factors, attachment styles, and personality traits) in their adherence to RM. Methods Questionnaires were sent by email to 108 mothers the day after they entered an RM program for pregnant women at risk of PIH. The Generalized Anxiety Disorder Assessment-7 and Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety and the severity of depression, respectively; an adaptation of the Pain Catastrophizing Scale was used to assess cognitive factors; and attachment and personality were measured with the Experiences in Close Relationships-Revised Scale (ECR-R), the Depressive Experiences Questionnaire, and the Multidimensional Perfectionism Scale, respectively. Results The moderate adherence group showed significantly higher levels of anxiety and depression, negative cognitions, and insecure attachment styles, especially compared with the over adherence group. The low adherence group scored significantly higher than the other groups on other-oriented perfectionism. There were no significant differences between the good and over adherence groups. Single linear regression showed that the answers on the PHQ-9 and ECR-R questionnaires were significantly related to the adherence rate. Conclusions This study demonstrates the relationships between adherence to RM and patient characteristics in women at risk of PIH. Alertness toward the group of women who show less than optimal adherence is essential. These findings call for further research on the management of PIH and the importance of individual tailoring of RM in this patient group. Trial Registration ClinicalTrials.gov NCT03509272; https://clinicaltrials.gov/ct2/show/NCT03509272

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Impact of a Patient-Centered Behavioral Economics Intervention on Hypertension Control in a Highly Disadvantaged Population: a Randomized Trial

et al. 2019

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BACKGROUND: Uncontrolled hypertension contributes to disparities in cardiovascular outcomes. Patient intervention strategies informed by behavioral economics and social psychology could improve blood pressure (BP) control in disadvantaged minority populations. OBJECTIVE: To assess the impact on BP control of an intervention combining short-term financial incentives with promotion of intrinsic motivation among highly disadvantaged patients. DESIGN: Randomized controlled trial. PARTICIPANTS: Two hundred seven adults (98% African American or Latino) aged 18 or older with uncontrolled hypertension attending Federally Qualified Health Centers. INTERVENTION: Six-month intervention, combining financial incentives for measuring home BP, recording medication use, BP improvement, and achieving target BP values with counseling linking hypertension control efforts to participants' personal reasons to stay healthy. MAIN MEASURES: Primary outcomes: percentage achieving systolic BP (SBP) < 140 mmHg, percentage achieving diastolic BP (DBP) < 90 mmHg, and changes in SBP and DBP, all after 6 months. Priority secondary outcomes were SBP < 140 mmHg, DBP < 90 mmHg, and BP change at 12 months, 6 months after the intervention ended. KEY RESULTS: After 6 months, rates of achieving target BP values for intervention and control subjects respectively was 57.1% vs. 40.2% for SBP < 140 mmHg (adjusted odds ratio (AOR) 2.53 (1.13-5.70)), 79.8% vs 70.1% for DBP < 90 mmHg (AOR 2.50 (0.84-7.44)), and 53.6% vs 40.2% for achieving both targets (AOR 2.04 (0.92-4.52)). However, at 12 months, the groups did not differ significantly in these 3 measures: 39.5% vs 35.0% for SBP (AOR 1.20 (0.51-2.83)), 68.4% vs 75.0% for DBP (AOR 0.70 (0.24-2.09)), and 35.5% vs 33.8% for both (AOR 1.03 (0.44-2.42)). Change in absolute SBP and DBP did not differ significantly between the groups at 6 or 12 months. Exploratory post hoc analysis revealed intervention benefit only occurred among individuals whose providers intensified their regimens, but not among those with intensification but no intervention. CONCLUSIONS: The intervention achieved short-term improvement in SBP control in a highly disadvantaged population. Despite attempts to enhance intrinsic motivation, the effect was not sustained after incentives were withdrawn. Future research should evaluate combined patient/provider strategies to enhance such interventions and sustain their benefit. TRIAL REGISTRATION: NCT01402453; http:// clinicaltrials.gov/show/NCT01402453 KEY WORDS: hypertension; healthcare disparities; patient behavior; financial incentives, behavioral economics. J Gen Intern Med

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Automedida da pressão arterial para o controle das cifras tensionais e para a adesão ao tratamento

Abstract: Background: The measurement of blood pressure (BP) by the patient himself without strict protocols, adequate training, and validated equipment at their own household is defined as self measured blood pressure (SMBP).

Cited by 14 publications

References 18 publications

Manual educativo para automedida da pressão arterial no controle de pacientes hipertensos cardiopatas

Manual educativo para automedida da pressão arterial no controle de pacientes hipertensos cardiopatas

Relationship Between Adherence to Remote Monitoring and Patient Characteristics: Observational Study in Women With Pregnancy-Induced Hypertension

Impact of a Patient-Centered Behavioral Economics Intervention on Hypertension Control in a Highly Disadvantaged Population: a Randomized Trial

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