Authors (including presenting author) :
Wan KS, Chu YM, Wong YH, Wong HK, Lui HT
Affiliation :
Department of Medicine, Tseung Kwan O Hospital
Introduction :
Based on the updated research evidence on the recommendations of US preventive strategies task force (2021) and American Heart Association (2019), BP variability, low systolic BP and nocturnal BP dip is associated with adverse cardiovascular outcomes. We would like to empower stroke patients with hypertension to have home blood pressure monitoring.
Objectives :
(1)To increase the awareness of blood pressure monitoring and patient participation in disease management (2)To introduce an effective practice of home blood pressure monitoring to patient according to updated evidence (3)To explore the association among blood pressure monitoring, treatment adjustment and risk of recurrent stroke (4)To introduce a brain health model to enhance better health management
Methodology :
According to the updated literature search and review, two questionnaires were designed for patients attending Stroke Nurse Clinic,(1) a home blood pressure monitoring record with clear instructions for patient to fill at home, (2) a questionnaire about health and disease management and answered by patient while waiting for nurse clinic. Stroke nurse reviewed these questionnaires and clarified the misconception on blood pressure management and introduced the evidence based brain health model to patient. Outcome measure were (1) Review of drug profile of patient, (2) Pre and Post clinic questionnaire analysis.
Result & Outcome :
The study was started from 5/10/2020 to 29/3/2021. Total 81 stroke patients with hypertension were reviewed. There were 52 male patient and 29 female patient. The mean age was 68 years old. 73% of them had home blood pressure monitoring. Among them, five patients were found to have BP variability and 7 patients had systolic BP lower than 120 mmHg. These patients were advised to bring their blood pressure record to attend medical follow- up. 5 patients had their antihypertensive medication reduced by physician. Moreover, we found that patients has increased their disease management and understanding after using questionnaires. The following was the result after analyzing the questionnaires. Patients acknowledge their stroke risks increased from 14.8% to 82.3%. Patients willing to read drug pamphlet increased from 32% to 71.8%. Patients understand the effect of their drugs increased from 38.3% to 91.7%. Patients observe the side-effect of drugs increased from 17.3% to 52.1%. No patient had recurrent stroke in this period.
