The use of a telemedicine system to self-report blood pressure and other health data remotely seems to help patients improve their blood pressure and make positive lifestyle changes, according to a study funded by the Agency for Healthcare Research and Quality.
In a six-month trial, 241 patients with high blood pressure—a systolic rate of 140 mmHg or higher—but no evidence of heart disease were placed into one of two care groups. In the first, participants received standard care from their primary-care physicians, but generally had no communication between the initial appointment and the six-month follow-up. The second group of patients were trained to monitor their blood pressure at home, using a cuff, and report those findings, as well as heart rate, weight, daily steps taken and tobacco use. Participants submitted the data to their physicians via telephone or Internet twice a week and received information and guidance in return to help them manage their blood pressure.
Although almost all participants were successful in lowering their systolic blood pressure, and about half achieved their goal rate, the non-diabetic patients in the telemedicine group fared much better. On average, those participants lowered their blood pressure by 19 mmHg, whereas the control group averaged a 12 mmHg reduction in systolic rate.
“It seems that when asymptomatic patients with hypertension are encouraged to measure their blood pressure, record their numbers into a database, track progress and get continuous clinical advice and feedback, they are better able to manage their blood pressure and, thereby, reduce their risk of serious health problems,” Dr. Alfred Bove, past president of the American College of Cardiology and the study's lead investigator, said in a news release.
Through the study, researchers also discovered that nondiabetics experienced a more significant reduction in blood pressure than the diabetic patients—58.2% for nondiabetics as compared to 45.2% for diabetics. But according to Bove, it doesn't mean that diabetics can't derive benefit from a telemedicine arrangement.
“Basically what we're doing with this tool is modifying behavior, and diabetics are already in a system of care—they're used to measuring their blood glucose, so they pay attention to [blood pressure] regardless of usual care or telemedicine,” Bove said in the release. “Hypertensive patients, however, are asymptomatic; they don't have any long-term system of care… the telemedicine system is a process for reminding them to measure their blood pressure and manage their blood pressure.”
This is not the first study to demonstrate the benefits of a telemedicine program, but what made this one unique was its focus on an underserved urban Philadelphia population. Bove explained that this particular group is more prone to heart disease, and therefore needs a system for earlier monitoring in order to reduce the risk of cardiac events. He suggested that automated kiosks that measure blood pressure and are directly connected to electronic health-record systems be established in community centers.
The study will be presented by Bove on March 10 in San Francisco at the American College of Cardiology's 62nd Annual Scientific Session. The American College of Cardiology is a not-for-profit organization that includes 43,000 physicians, surgeons, nurses, physician assistants, pharmacists and practice managers. Its annual session provides a forum for cardiologists and cardiovascular specialists to share their findings for treatment and prevention options.