Home monitoring service improves mean arterial pressure in patients with essential hypertension. A randomized, controlled trial

• HIT Description: Telemedicine and computerized communication systems. More info...
  
• Purpose of Study: Determine the efficacy of a telecommunication service in reducing blood pressure in patents with essential hypertension.
  
• Years of study: 1999-2000
  
• Study Design: RCT
  
• Outcomes: Impact on patient satisfaction, Impact on health care effectivness/quality
  

• Settings: One hundred twenty-one adults with essential hypertension who were under evaluation for a change in antihypertensive therapy participated in the study conducted at university-affiliated primary care outpatient clinics in Syracuse, New York.
• Intervention: Patients with a home service consisting of automatic transmission of blood pressure data over telephone lines, computerized conversion of the information into report forms, and weekly electronic transmission of the report forms to physicians and them were compared to usual care patients.
• Evaluation Method: Measures of blood pressure, and change in mean arterial pressure at baseline and exit, and patient satisfaction.
• Quality of Care and Patient Safety Outcome: Mean arterial pressure decreased by 2.8 mm Hg in patients receiving the home service and increased by 1.3 mm Hg in patients receiving usual care (P = 0.013 for the difference). Mean diastolic blood pressure decreased by 2.0 mm Hg for home service but increased by 2.1 mm Hg for usual care (P = 0.012 for the difference). Mean systolic blood pressure decreased by 4.9 mm Hg for home service and 0.1 mm Hg for patients receiving usual care (P = 0.047 for the difference). Among African-American patients, mean arterial pressure decreased by 9.6 mm Hg in those receiving home service and increased by 5.25 mm Hg in those receiving usual care (P = 0.047).
• Changes in efficiency and productivity: Ninety-two percent of patients in both groups agreed that they were receiving good care. Ninety-six percent of patients in the telemedicine group agreed that their physician had all the information needed to diagnose or treat them compared to 89% in the usual care group.