Research Activities, July 2013
Telemedicine may be a useful tool for managing hypertension, particularly among nondiabetic patients
Health Information Technology
Patients with hypertension, who use a telemedicine system (either an interactive telephone system or a secure Web site) to report clinical data to their primary care provider twice a week, are more likely to reach their blood pressure (BP) goal at the end of 6 months than patients who receive standard care, according to a new study.
Alfred A. Bove, M.D., Ph.D., of Temple University School of Medicine, and coinvestigators examined telemedicine use and hypertension management among an urban group of primarily black patients from the Temple University Medical Center in Philadelphia, PA, and the Christiana Health Care Center in Wilmington, DE. Patients had clinical data (blood pressure, heart rate, weight, number of steps walked daily, and tobacco usage) collected when randomly assigned to the telemedicine or standard care group. Those in the telemedicine group were asked to submit the same data twice weekly by calling in to the phone system or logging onto the Web site. Most individuals used the interactive telephone system (65 percent of reports).
At the end of the 6-month study, 58.8 percent of the 68 nondiabetic patients assigned to the telemedicine group were at goal BP versus 52.1 percent of 73 nondiabetic standard care patients. In contrast, 31 diabetic patients assigned to the telemedicine group were less likely to achieve goal BP (45.2 percent) than either group of nondiabetic patients.
Standard care patients, in general, did not change their use of medications, while the telemedicine group had a significant 10 percent increase in the number of BP medications. No difference was noted in medication adherence between the two groups, or between nondiabetic and diabetic patients. The study was funded in part by AHRQ (HS17202).
More details are in "Managing hypertension in urban underserved subjects using telemedicine—A clinical trial," by Alfred A. Bove, M.D., Ph.D., Carol J. Homko, R.N., Ph.D., William P. Santamore, Ph.D., and others in the April 2013 American Heart Journal 165(4), pp. 615-621.