PATIENT-ORIENTED ASSESSMENT OF BLOOD PRESSURE TELEMONITORING AND REMOTE COUNSELING IN HYPERTENSIVE PATIENTS: A PILOT PROJECT. (June 2018)

• Record Type: Journal Article
• Authors: Ionov, M.; Yudina, Y.; Avdonina, N.; Emelyanov, I.; Kurapeev, D.; Zvartau, N.; Konradi, A.
• Is Part Of: Journal of hypertension. Volume 36(2018)Supplement 1
• Publication Date: 2018-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000539143.48753.e6
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: To evaluate patient-oriented endpoints and antihypertensive effectiveness of blood pressure (BP) telemonitoring and distant counseling (TMDC) in uncontrolled hypertension (HTN). Figure. No caption available. Design and method: Patients with uncontrolled HTN were assigned to TMDC group (110 patients; 74 males, mean age 51, 2 ± 17, 0 years) or to age, sex and BP level-matched control group (80 patients; 63 males, mean age 50, 8 ± 15, 9 years). Both groups had baseline and 3-months follow-up clinic visits with blood pressure measurement and evaluation of patient-reported outcomes by Hospital Anxiety and Depression Scale («HADS») and «SF-36». At baseline visit control group patients received standard recommendations. TMDC patients were educated with detailed technical instructions on BP self-monitoring and trained for the use of website and mobile application. Remote consultations were allowed at any time by demand during a 3-month program, the frequency and reasons were also registered. Results: After the 3-month period the decrease in office systolic (SBP) and diastolic (DBP) BP levels was significantly higher in TMDC group compared to the controls: −22 ± 12, 4 versus −8, 6 ± 22, 4 mmHg for SBP (p = 0, 005) and −13, 6 ± 10, 8 versus −7 ± 11, 3 mmHg for DBP (p = 0, 02). Target office BP level (< 140/90 mmHg) was achieved in 82 patients (75%) and 16 patients (20%), respectively (χ 2 = 20, 8; p < 0, 01). During 3-month program every patient in TMDC group required at least 1 remote consultation (from 1 to 8, mean n = 4) for different reasons which in 36 cases (33%) lead to change in antihypertensive therapy. At 3-month visit TMDC group demonstrated reduction in anxiety and depression according to HADS compared to baseline data (–1, 2 and –1, 8 score, respectively, p < 0, 05) and improvement in physical life quality (+ 9 ± 3, 3 points SF-36, p = 0, 04). In control group patient-reported outcomes remained unchanged. Conclusions: Results demonstrated that 3-month telemonitoring program in patients with uncontrolled HTN provides additional antihypertensive effect and improving of patient-reported outcomes. These results can be explained by better patients-doctor interaction and improvement of patient compliance.