Central Asian Journal of Medicine


Introduction. The present research covers data and analysis on implementation of the "Algorithm of computer program for personalized dynamic observation of hypertensive patients in primary health care". In the health care system of Uzbekistan, as well as in the systems of other countries throughout the world, AH is a topical issue. Study objective: To increase the effectiveness of treatment and clinical observation of patients with hypertensive disease (HD) in primary health care settings. Material and methods: In the process of research data (for the past five years) of 222 randomly selected medical histories of patients with arterial hypertension, being under regular medical examination in family polyclinics (n=54) and in some rural health clinics of the Republic of Uzbekistan (n=168), was analyzed. Results of the analysis of the medical histories were compared with the results of examination of patients (questioning, medical examination, anthropometry, measurement of blood pressure, cholesterol test, etc.). Results and discussion: All the patients have been under the supervision for 2 years with subsequent repeated check-up and medical examination. In the core group (patients aged from 45 to 71 years, average age - 51.75 + 1.85 years; 29.5% males, 70.4% females), the patients were broken down by stages as follows: Stage I hypertensive disease - 45 (36, 8%) patients; Stage II hypertensive disease - 62 (50.8%) patients; Stage III hypertensive disease - 15 (12.2%) patients. Hypertensive crisis was observed in 40 (32.7%) patients. The experimental group consisted of 114 patients (80 (70.1%) females and 34 (29.8%) males, aged 44-75 years, average age - 52.6 ± 1.62 years), they were treated by the traditional method and did not participated in the training. In the core group, as opposed to the experimental group, there were positive changes in the lipid profile: the number of arterial hypertension patients with hypertriglyceridemia decreased from 19.6% to 11.4% (p <0.001); the number of arterial hypertension patients hypercholesterolemia decreased from 56.5% to 27.0% (p <0.001). Taking into account the peculiarities of the existing model of prophylactic medical observation and using the accumulated data of numerous evidence medicine-based scientific studies of recent years, we have improved (personalized) and implemented into the inpatient practice of PHC physicians the individual tactic to observe hypertensive patients. For this purpose, there was developed the algorithm of a computer program to identify and individual tactic for dynamic observation of hypertensive patients, adjusted to PHC settings. Conclusions: The organization of training at the "school for hypertensive patients" led to a significant increase in the number of hypertensive patients with constant self-monitoring of blood pressure. The algorithm of electronic program for personalized dynamic observation of hypertensive patients was created on the base of obtained results of anamnesis, anthropometry, and laboratory and instrumental tests. Implementation of the algorithm of electronic program creates the possibility of routine detection of abnormal changes in the health status of hypertensive patients in the early stages of their development and the reasons of inadequate disease control. This increases the effectiveness of HD prevention and treatment at the primary health care level.

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