Authors (including presenting author) :
So MK, Tong YC
Affiliation :
Occupational Therapist, Family Medicine and Primary Health Care Department, KWC
Introduction :
White-coat hypertension (WCHT) and white-coat effect (WCE) are commonly detected in primary health care setting, some studies reported that this phenomenon may increase long-term cardio-vascular risk. One of the hypothetical causes of increased blood pressure (BP) in clinic setting is due to anxiety reaction, however, currently no specific treatment is provided for those patients in KWC. A new Occupational Therapy (OT) program using relaxation techniques with occupational lifestyle redesign was implemented and aimed to enhance patients’ stress copying skills, reflect actual BP in clinical setting and enhance patient with chronic disease management.
Objectives :
To review the effectiveness of a new OT program in chronic disease management.
Methodology :
A new OT program was started since Jan 2019 to Jan 2020. Patients would attend an education group, followed up by two individual consultations. In the first individual follow up (1st OT FU), relaxation technique was reviewed and practiced, pre- and post- comparison on BP was measured. In 2nd OT FU, BP was measured by patient alone to assess the generalization of relaxation technique into routine clinical FU without therapist guided. Phone FU on the clinic BP after 6 months post education group was arranged to assess the long term effect of the OT program.
Result & Outcome :
Total 77 patients (58 female) with mean age 67 years old (SD=10) completed both education group and 2 individuals FU. 81% of patients reported anxiety during clinical FU. In 1st OT FU, the mean systolic BP was found significantly reduced by 14 mmHg, from 152 to 137 mmHg (p< 0.01) after practising relaxation technique. In 2nd OT FU, the mean systolic BP during routine clinic FU was maintained 137 mmHg. There is no significantly difference when compared with the post relaxation BP in 1st OT FU, which reflected that patients were able to generalize the relaxation technique into daily practice without therapist’s supervision. In the post 6 months phone FU, 40 patients were reviewed and the mean systolic BP during recent clinic FU was 140 mmHg. There is no significantly difference when compared with the clinic FU in 2nd OT FU, this proved the long term effect of the OT program. For those patients with good compliance on home program, the mean systolic BP even maintained in a lower level of 134 mmHg.
Those positive results showed the new OT program on WCHT and WCE was effective in chronic disease management with long term effect.
