Family Doctor Contract Services and Awareness of Blood Pressure Measurement Among Hypertension Patients: A Cross-Sectional Study in Rural Shandong, China

Abstract

Background: Some studies found that family doctor contract services (FDCSs) had positive impact on the self-measurement behaviors of hypertension patients. However, evidence concerning the association between FDCSs and blood pressure measurement awareness among hypertension patients is not clear. Objective: This study aims to explore the relationship between FDCSs and blood pressure measurement awareness among the hypertension patients, and examine whether there is a difference in this relationship among middle-aged and aged adults in rural Shandong, China. Methods: A multi-stage stratified random sampling was adopted in 2018 in Shandong Province to conduct a questionnaire survey among the sample residents, in which 982 hypertension patients were included in the study. Pearson chi-square test and logistic regression model were employed using SPSS 24.0 to explore the association between FDCSs and blood pressure measurement awareness. Results: 76.8% of hypertension patients would measure blood pressure regularly. The blood pressure measurement awareness of the signing group was significantly higher than that of the non-signing group when controlling other variables (P < 0.001, OR = 2.075, 95% CI 1.391–3.095). The interaction of age and contracting status were significantly correlated with blood pressure measurement awareness (P = 0.042, OR = 1.747, 95% CI 1.020–2.992; P = 0.019, OR = 2.060, 95% CI 1.129–3.759). Factors including gender (P = 0.011, OR = 0.499, 95% CI 0.291–0.855), household income (P = 0.031, OR = 1.764, 95% CI 1.052–2.956), smoking status (P = 0.002, OR = 0.439, 95% CI 0.260–0.739), sports habits (P < 0.001, OR = 2.338, 95% CI 1.679–3.257), self-reported health (P = 0.031, OR = 1.608, 95% CI 1.043–2.477), distance to the village clinic (P = 0.006, OR = 1.952, 95% CI 1.208–3.153) and medications (P < 0.001, OR = 3.345, 95% CI 2.282–4.904) were also found to be associated with the blood pressure measurement awareness of hypertension patients. Conclusion: The government should take efforts to strengthen publicity and education of family doctors and pay more attention to uncontracted, middle-aged, female patients and patients with unhealthy life behaviors to improve the blood pressure measurement awareness.