Home based telemedicine intervention for patients with uncontrolled hypertension: - A real life - Non-randomized study

Palmira Bernocchi, Simonetta Scalvini, Fabio Bertacchini, Francesca Rivadossi, Maria Lorenza Muiesan

Research output: Contribution to journalArticle

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.

Original languageEnglish
Article number52
JournalBMC Medical Informatics and Decision Making
Volume14
Issue number1
DOIs
Publication statusPublished - Jun 12 2014

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Telemedicine
Blood Pressure
Hypertension
Telephone
Nurses
Reading
Physicians
Cardiology
Pharmaceutical Preparations
Antihypertensive Agents
Appointments and Schedules

Keywords

  • Blood pressure
  • Hypertension
  • Telemedicine
  • Telemonitoring

ASJC Scopus subject areas

  • Health Informatics
  • Health Policy

Cite this

Home based telemedicine intervention for patients with uncontrolled hypertension : - A real life - Non-randomized study. / Bernocchi, Palmira; Scalvini, Simonetta; Bertacchini, Fabio; Rivadossi, Francesca; Muiesan, Maria Lorenza.

In: BMC Medical Informatics and Decision Making, Vol. 14, No. 1, 52, 12.06.2014.

Research output: Contribution to journalArticle

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