Repeated measures-based comparison of patient-reported outcomes for patients with hypertension having different medication regimens and blood pressure levels

Abstract:

Objective To compare the therapeutic effects of different medication regimens in patients with hypertension with different blood pressure levels based on patient reported outcomes（PROs），and to provide a reference for clinicians to choose medication regimens.Methods A total of 625 community patients with hypertension who were taking antihypertensive medications underwent a baseline PRO measure and three repeated-measures of PRO（once every three months）. Repeated-measures analysis of variance （ANOVA） was used to compare the PRO of six combinations generated with two medication regimens（single medications and combined medications） and three blood pressure levels（grade-1 hypertension，grade-2 hypertension，and grade-3 hypertension） at different time points.Results Repeated-measures ANOVA results showed that patients with hypertension having different medication regimens and blood pressure levels had varying degrees of fluctuations in PRO scores across three repeated measures. For patients with grade-1 hypertension on single medications，PRO scores in physical health，mental health，social health，spiritual/faith-related health，and the specific module fluctuated downward. For both patients with grade-2 hypertension and those with grade-3 hypertension on single medications，the scores in mental health，social health，and spiritual/faith-related health fluctuated upward. There were no significant differences in PRO scores in physical health among grade-1，-2，and -3 hypertensive patients on combined medications. There was a downward trend in mental health-related PRO score in patients with grade-2 hypertension on combined medications. The PRO score in social health showed a fluctuating upward trend in patients with grade-3 hypertension on combined medications. For patients with grade-1 hypertension and those with grade-2 hypertension on combined medications，the PRO score in spiritual/faith-related health fluctuated downward and upward，respectively. There was a downward trend in the specific module score of patients with grade-2 hypertension on combined medications. The total PRO score declined in patients with grade-1 hypertension and fluctuated upward in patients with grade-2 and grade-3 hypertension，regardless of single or combined medications.Conclusion Patients with different grades of hypertension have varying PRO scores with single and combined medications，and clinicians can refer to patients’ PROs when choosing medication regimens.