Home based telemedicine intervention for patients with uncontrolled hypertension: - a real life - non-randomized study

BMC Medical Informatics and Decision Making

Research Article

Francesca Rivadossi¹  Maria Lorenza Muiesan²  Fabio Bertacchini²  Palmira Bernocchi³  Simonetta Scalvini⁴ 

[1] Department of Cardiology, Fondazione Salvatore Maugeri, IRCCS. Institute of Lumezzane, Brescia, Italy;Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy;Fondazione Salvatore Maugeri, IRCCS. Telemedicine Service - Institute of Lumezzane, Brescia, Italy;Fondazione Salvatore Maugeri, IRCCS. Telemedicine Service - Institute of Lumezzane, Brescia, Italy;Department of Cardiology, Fondazione Salvatore Maugeri, IRCCS. Institute of Lumezzane, Brescia, Italy;

关键词: Hypertension;    Blood pressure;    Telemedicine;    Telemonitoring;   

DOI  :  10.1186/1472-6947-14-52

 received in 2014-02-25, accepted in 2014-05-28,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundControl of blood pressure is frequently inadequate in spite of availability of several classes of well tolerated and effective antihypertensive drugs. Several factors, including the use of suboptimal doses of drugs, inadequate or ineffective treatments and poor drug compliance may be the reason for this phenomenon. The aim of the current non- randomized study was to evaluate the effectiveness of a Home-Based Telemedicine service in patients with uncontrolled hypertension.Methods74 patients were enrolled in a Home Based Telemedicine group and 94 patients in the Usual Care group. At baseline and at the end of the study, patients in both groups were seen in a cardiology office. Patients in Home Based Telemedicine group additionally were followed by a physician-nurse, through scheduled and unscheduled telephone appointments. These patients also received a blood pressure measuring device that could transmit the readings to a central data monitor via secure data connection.ResultsDuring the study period (80 ± 25 days), a total of 17401 blood pressure measurements were taken in the Home Based Telemedicine group corresponding to 236 ± 136 readings per patient and a mean daily measurement of 3 ± 1.7. The scheduled telephone contacts (initiated by the nurse) equaled to 5.2 ± 4.3/patient (370 in total) and the unscheduled telephone contacts (initiated by the patients) were 0.4 ± 0.9/patient (30 in total). The mean systolic blood pressure values decreased from 153 ± 19 mmHg to 130 ± 15 mmHg (p < 0.0001) at the end of the study and diastolic blood pressure values decreased from 89 ± 10 mmHg to 76 ± 11 mmHg (p < 0.0001). In the Usual Care group, the mean systolic blood pressure values decreased from 156 ± 16 mmHg to 149 ± 17 mmHg (p < 0.05) at the end of the study and diastolic blood pressure values decreased from 90 ± 8 mmHg to 86 ± 9 mmHg (p < 0.05). The changes in drug therapy initiated following telephone contacts were 1.81 ± 1.73 per patient.ConclusionsThe addition of a structured physician-nurse approach supported by remote telemonitoring of blood pressure is likely to improve outcome in patients with uncontrolled hypertension.

【 授权许可】

CC BY   
© Bernocchi et al.; licensee BioMed Central Ltd. 2014