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

Bernocchi P, Scalvini S, Bertacchini F, Rivadossi F, Muiesan ML - BMC Med Inform Decis Mak (2014)

Bottom Line: Control of blood pressure is frequently inadequate in spite of availability of several classes of well tolerated and effective antihypertensive drugs.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).

View Article: PubMed Central - HTML - PubMed

Affiliation: Fondazione Salvatore Maugeri, IRCCS, Telemedicine Service - Institute of Lumezzane, Brescia, Italy. palmira.bernocchi@fsm.it.

ABSTRACT

Background: Control 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.

Methods: 74 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.

Results: During 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.

Conclusions: The addition of a structured physician-nurse approach supported by remote telemonitoring of blood pressure is likely to improve outcome in patients with uncontrolled hypertension.

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Related in: MedlinePlus

Summary diagram of the home-based blood pressure telemonitoring system. BP indicates blood pressure.
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Figure 1: Summary diagram of the home-based blood pressure telemonitoring system. BP indicates blood pressure.

Mentions: Patients in this group were supplied with a blood pressure measuring device (model A&D UA-767 Plus BT) and a mobile phone which had a Java 2 Platform Micro Edition (J2ME) application installed. The A&D sensor could transmit the BP values to a mobile through Bluetooth connection and it could send them to a server via secure data connection. At the beginning of the study an educational meeting was held where the nurse explained the study to the patients and taught them the correct way to use the home BP instruments and the mobile phone and the correct way to measure BP based on the published guidelines [21]. Figure 1 shows a summary diagram of the system.


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

Bernocchi P, Scalvini S, Bertacchini F, Rivadossi F, Muiesan ML - BMC Med Inform Decis Mak (2014)

Summary diagram of the home-based blood pressure telemonitoring system. BP indicates blood pressure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4066708&req=5

Figure 1: Summary diagram of the home-based blood pressure telemonitoring system. BP indicates blood pressure.
Mentions: Patients in this group were supplied with a blood pressure measuring device (model A&D UA-767 Plus BT) and a mobile phone which had a Java 2 Platform Micro Edition (J2ME) application installed. The A&D sensor could transmit the BP values to a mobile through Bluetooth connection and it could send them to a server via secure data connection. At the beginning of the study an educational meeting was held where the nurse explained the study to the patients and taught them the correct way to use the home BP instruments and the mobile phone and the correct way to measure BP based on the published guidelines [21]. Figure 1 shows a summary diagram of the system.

Bottom Line: Control of blood pressure is frequently inadequate in spite of availability of several classes of well tolerated and effective antihypertensive drugs.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).

View Article: PubMed Central - HTML - PubMed

Affiliation: Fondazione Salvatore Maugeri, IRCCS, Telemedicine Service - Institute of Lumezzane, Brescia, Italy. palmira.bernocchi@fsm.it.

ABSTRACT

Background: Control 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.

Methods: 74 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.

Results: During 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.

Conclusions: The addition of a structured physician-nurse approach supported by remote telemonitoring of blood pressure is likely to improve outcome in patients with uncontrolled hypertension.

Show MeSH
Related in: MedlinePlus