Authors (including presenting author) :
Cheng CF(1), Mok SS(1), HO HW(2), Chan KL(2), Tse KP(3), Woo CH(1), Poon KH(1), Wong N(1), Tsoi YK(1)
Affiliation :
(1)Department of Medicine, Haven of Hope Hospital (2)Department of Physiotherapy, Haven of Hope Hospital (3)Department of Occupational Therapy, Haven of Hope Hospital
Introduction :
Orthostatic Hypotension (OH) is a common condition, especially among the elderly, marked by a significant drop in blood pressure when moving from a lying to a standing position. This condition increases the risk of falls, syncope, and related injuries, leading to higher morbidity and increased hospitalizations. Despite its clinical importance, OH is often underdiagnosed and poorly managed due to the absence of standardized protocols and coordinated multidisciplinary care. This project aims to bridge these gaps by implementing a Rapid Pathway for the diagnosis and management of OH in a hospital setting, thereby enhancing patient safety and improving clinical outcomes.
Objectives :
1) To prevent complications of Orthostatic Hypotension through early identification and timely intervention 2) To improve patient outcomes through systematic interventions that incorporate both pharmacological and non-pharmacological strategies
Methodology :
This program employed a multidisciplinary rapid response strategy to enhance care quality for patients with Orthostatic Hypotension (OH). Initial screening and regular monitoring of blood pressure were conducted by nurses, who also administered non-pharmacological interventions, including hydration rounds and patient education. A standardized protocol for postural blood pressure measurement was implemented, with readings taken at baseline and post-intervention in both sitting and standing positions, evaluated at 0 and 3 minutes to gauge physiological responses. Moreover, medical evaluations were performed by physicians, who initiated disease stabilization measures and prescribed pharmacological treatments as necessary. Physiotherapists introduced physical maneuvers to mitigate postural hypotension, while Occupational therapists prescribed and evaluated the efficacy of abdominal binder and pressure garments to ensure a comprehensive approach to managing OH in Geriatric patients.
Result & Outcome :
The project was conducted from May to December 2024, involving 32 patients with a mean age of 87.4 years. A total of 240 clinical samples of postural blood pressure were collected. The intervention demonstrated significant improvements in managing orthostatic hypotension, with 27 patients (84.3%) showing improved systolic blood pressure following the interventions from 5 to 62 mmHg (mean:18.45), while 20 patients (62.5%) showing improved diastolic blood pressure from 1 to 21 mmHg (mean:8.57). Additionally, 19 patients (59.3%) corrected their postural hypotension after the interventions, defined as a reduction in systolic blood pressure drop to less than 20 mmHg and/or diastolic blood pressure drop to less than 10 mmHg between 0 and 3 minutes after transitioning to sitting or standing positions.
