Telemedicine improves medication management, patient care
Internet-based telemedicine systems appear to lead to more appropriate and effective pharmacotherapy, better blood pressure control and an overall reduction in cardiovascular risk compared to conventional, periodic office visits, according to research presented today at the American College of Cardiology's 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field.
Patients who reported blood pressure readings more frequently via a web-based portal received more timely treatment decisions and medication adjustments from their health care team compared to a control group of hypertensive patients who had routine office visits. These findings have important implications for clinical practice given that aside from lifestyle changes antihypertensive medications are the most effective way to help patients lower their blood pressure. As many as 65 million American adults have high blood pressure, and roughly 74 percent take medication for it, according to the Centers for Disease Control and Prevention.
"The ongoing monitoring and reporting of blood pressure levels seems to bring about important changes in physician prescribing habits, which we think ultimately benefit patients," said Val Rakita, MD, internal medicine resident at Temple University Hospital and the study's co-investigator. "Based on our findings, physicians appear to prescribe more blood pressure medications for those patients who continue to have high blood pressure despite the medications they are on. In fact, in one subset of patients, not only did we find they were prescribed more blood pressure medications, it also actually led to a larger blood pressure reduction compared to all other groups."
In this study, patients from two large medical centers were recruited and randomized to receive either usual care or telemedicine with usual care. Patients in the telemedicine group received counseling on cardiovascular disease risk reduction and were given a home blood pressure cuff and trained on how to use it. They were asked to report their blood pressure, heart rate, weight, steps taken per day, and tobacco use twice weekly for six months. By the end of the six-month intervention, medications prescribed to those in the control group were virtually unchanged, while there was a small, but significant, increase in the number of medications ordered ( 2.20±1.20 to 2.34±1.15, p=0.004) for patients in the telemedicine group.
Dr. Rakita says that prescribing more medication in the telemedicine group did not signify overtreatment, but was a reflection of more timely decisions to increase and/or adjust medications based on patient self-monitoring and reporting.
Unlike other types of telemedicine, which may include telephone interactions, this study looked at an internet-based system that supported ongoing communication between patients and health care providers.
"This allows for greater convenience for both sides and most likely led to the better results," Dr. Rakita said. "High blood pressure is one of the most important risk factors for cardiovascular disease, which is the number one cause of death in America. Employing an internet-based patient-physician communication system that can help lower blood pressure could make it possible to reduce patients' cardiovascular risk."
This was a secondary analysis of a telemedicine trial of 241 patients with uncontrolled hypertension (BP≥150/90 mmHg). More than half of study participants (56.8 percent) were taking one or two blood pressure-lowering medications at the start of the study. The initial average blood pressure was 156/89±14/11 among all patients. All patients had baseline and six-month follow-up visits. Monthly reports on blood pressure and treatment guidelines were provided to both the patient and physician in the telemedicine group.
Although there was no significant difference in the decrease in blood pressure between the two groups overall, the primary group of non-diabetic patients using telemedicine was found to have lower blood pressure compared to all other groups. Dr. Rakita said it is reasonable to believe that the use of additional blood pressure medications in the telemedicine group would have translated to an associated drop in blood pressure in these patients had they been followed for a longer period of time.
"The goal of telemedicine is to reduce disease and the burden on the healthcare system in a cost-effective way," he said. "By showing that a relatively low-cost, internet-based telemedicine system can change physicians' prescribing habits and perhaps [lower] blood pressures, this can lead to obvious benefits to patients and the healthcare system."
Provided by American College of Cardiology
- Take your blood pressure meds before bed Oct 24, 2011 | not rated yet | 0
- Communicating your way to a healthy heart Mar 30, 2008 | not rated yet | 0
- Frequent doctor visits help diabetics lower blood pressure more quickly May 24, 2010 | not rated yet | 0
- Home monitoring, Web-based tool improves blood pressure control May 21, 2010 | not rated yet | 0
- Blood pressure medicines reduce stroke risk in people with prehypertension Dec 08, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
How many joules expended for a push up?
3 hours ago Just wondering if any of you can do the calculation that well approximates the amount of joules expended by a push up.
force to keep the folding doors
3 hours ago Hello, I would like to ask you to calculate the force F, which needed to keep the folding doors in this position. I would like to know what is the...
Confusion regarding direction of kinetic friction on inclined plane.
4 hours ago *please help! * The formula for kinetic friction acting on a sliding body is μkN When the body is sliding with constant velocity down an...
10 hours ago Alright, so in Pathfinder (like Dungeons and Dragons) there's a spell that allows you to lift/move stuff within 25 ft with 5 pounds of force. A...
12 hours ago So energy can only be converted... So when you squeeze the bulb on a blood pressure cuff, you are applying kinetic energy. Then the cuff fills with...
How does momentum, inertia and drag affect the motion of an object?
15 hours ago How does momentum and inertia affect changes in speed, when considering acceleration from thrust, or from decelleration from drag? Say, for a...
- More from Physics Forums - Classical Physics
More news stories
(HealthDay)—Blood levels of free fatty acids are associated with insulin resistance during young adulthood and cardiovascular risk factors in later adulthood, according to a study published online May 13 ...
Cardiology May 17, 2013 | not rated yet | 0 |
An experimental, inexpensive iPhone application transmitted diagnostic heart images faster and more reliably than emailing photo images, according to a research study presented at the American Heart Association's Quality ...
Cardiology May 17, 2013 | not rated yet | 0
Extracorporeal membrane oxygenation (ECMO), a procedure traditionally used during cardiac surgeries and in the ICU that functions as an artificial replacement for a patient's heart and lungs, has also been used to resuscitate ...
Cardiology May 17, 2013 | not rated yet | 0
Age has little to do with how patients should be treated after suffering a stroke, according to new research from the University of Georgia.
Cardiology May 17, 2013 | not rated yet | 0 |
Depressed middle-aged women have almost double the risk of having a stroke, according to research published in Stroke: Journal of the American Heart Association.
Cardiology May 16, 2013 | not rated yet | 0
The latest makeover to a massive psychiatric tome honored by some, reviled by others and even called the "Bible" of mental disorders is being released Saturday with a host of new changes.
54 minutes ago | not rated yet | 0
An increasing number of U.S. children are experiencing gastrointestinal issues that require interventions to resolve, according to research presented at Digestive Disease Week (DDW).
3 hours ago | not rated yet | 0 |
A new case of the deadly coronavirus has been detected in Saudi Arabia where 15 people have already died after contracting it, the health ministry announced on Saturday on its Internet website.
1 hour ago | not rated yet | 0
A ground-breaking advance in colonoscopy technology signals the future of colorectal care, according to research presented today at Digestive Disease Week(DDW). Additional research focuses on optimizing the minimal withdrawal ...
3 hours ago | 5 / 5 (1) | 0
Big names in medicine are set to give an upbeat assessment of the war on AIDS on Tuesday, 30 years after French researchers identified the virus that causes the disease.
11 hours ago | 5 / 5 (1) | 0
For combat veterans suffering from post-traumatic stress disorder, 'fear circuitry' in the brain never rests
Chronic trauma can inflict lasting damage to brain regions associated with fear and anxiety. Previous imaging studies of people with post-traumatic stress disorder, or PTSD, have shown that these brain regions can over-or ...
12 hours ago | 5 / 5 (1) | 0 |