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The Integrated Citizen Telemedical Care Service for Hypertension
Chen Mei Ju
telephone advice nursing
Objective: In this study, we developed an integrated service model for hypertension based on the Smart medical services system for managing chronic disease, which is called the Citizen Telemedical Care Service System (CTCS). The CTCS model specifies six domains: biosignal measurement and short-message alert, hypertension risk estimation report and consultation, clinic appointment service, video communication service, health program record, medical assistance referral and health education. This study tried (1) to establish the integrated service model, (2) to empower hypertension patients to allow self-management and improved hypertension control, and (3) to evaluate the acceptance and satisfaction of the CTCS model. Results will be used to reflect upon the services which the government is currently providing, and to determine if further investigation may be required to establish whether or not the service model currently provided succeeds in meeting the needs of hypertension patients. Method: The study was a quasi-experimental repeatedly designed to investigate measurement behaviors among two groups across different months from Jun. 2010 to Feb. 2011 to ultimately increase the frequency of BP measurement and improve hypertension control. The study included 200 patients who had unstable hypertension in three cardiologists’ clinics and were on antihypertensive medication. Two generalized estimating equations were used for the analysis of BP outcome in various months (6th and 9th) after the study intervention. At the end of the study, the satisfactions and the willing to pay for this service were collected. Results: After the CTCS model intervention, compared to the control group, the BP control improvement reached the significant differences. In the study process, the intervention group did not change the BP measurement habits. Especially, the abnormal BP subgroup after the short-message intervention, compared to baseline BP, the 9th and 6th average BP was improved. As for the satisfaction, most of the intervention group participants had the high satisfactions, and the willing to pay NT 500 for this service. The study established the standard service model for telehealth education and consultation by the telephone nursing. Conclusions: The overall findings suggested that CTCS Model interventions show promise as effective modes of treatment for specific health problems. Its remarkable results for blood pressure control of hypertension cases, but for cases of hypertension's home measuring blood pressure behaviour change is not significant. There were significant relationship between the perceiving usefulness and satisfactions. The next step should focus on the needs and demands of the participants for the telehealth that would facilitate the successful development of tele-health care model. Keyword: telehealthcare, telephone advice nursing, hypertension control
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