Assessment of the clinical efficacy of telemonitoring and distant counseling in patients with uncontrolled hypertension


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Abstract

The aim of the study was to investigate the mathematical correlation of the clinical efficacy of blood pressure telemonitoring and distant counseling (BPTM) in patients in uncontrolled hypertension (HTN). Telehealth tools are widely used in HTN management. However clinical efficacy of such interventions assessed mainly in groups investigated without its populational and attributable impact. Materials and methods. The total of 240 patients were included, then randomized in 2:1 manner to BPTM group (n=160, median age 47 y.o.) and control group (n=80, median age 49 y.o). The user - friendly and secure telehealth software was provided with mobile application (patients) and desktop (doctors) platforms which allowed storage and analysis of self-BP monitoring data and remote consultations. A three - month surveillance was designed with mandatory baseline and final face - to - face visits with the assessment of office systolic BP (oSBP). Mathematical evaluation was based on target SBP rates achieved in comparator groups and included the absolute efficacies (AE), the attributable efficacy (AtE), the relative efficacy (RE) and the population attributable efficacy (PAtE). Results. BPTM group characterized by larger decrease in SBP level compared with controls (-16.8±2.9 mm Hg versus -7.9±3.9 mm Hg; p<0.001). There were 120 and 16 patients with SBP on target by the end of the study in BPTM and control group respectively (AE 75±6.7% versus 20±8.8%, p<0.001). AtE was found to be 55.0±11.3%; RE was estimated as 3.75 (95% CI 1.94-5.56) and PAtE was found to be 36.7% (95% CI 24.1-49.2). Number needed to treat to achieve target BP with BPTM was estimated as 1.8. Conclusion. Implementing BPTM into management strategy significantly increases the likelihood of BP control. The results of the study indicate a pronounced effect of BPTM on the achievement of target BP.

About the authors

M V Ionov

Federal State Budgetary Institution “V.A. Almazov National Medical Research Center”; Saint-Petersburg National Research University of Information Technologies, Mechanics and Optics

Email: ionov_mv@almazovcentre.ru
аспирант, м.н.с. научно-исследовательской лаб. патогенеза и терапии артериальной гипертензии научно-исследовательского отд. артериальной гипертензии ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава России; м.н.с. института трансляционной медицины ФГАОУ ВО «Санкт-Петербургский национальный исследовательский университет информационных технологий, механики и оптики» (Университет ИТМО); ORCID: 0000-0002-3664-5383 Saint-Petersburg, Russia

O V Zhukova

Federal State Budgetary Educational Institution of Higher Education “Privolzhsky Research Medical University”

к.фарм.н., доцент каф. управления и экономики фармации и фармацевтической технологии ФГБУ ВО «Приволжский исследовательский медицинский университет» Минздрава России, ORCID: 0000-0002-6454-1346 Nizhny Novgorod, Russia

N E Zvartau

Federal State Budgetary Institution “V.A. Almazov National Medical Research Center”; Saint-Petersburg National Research University of Information Technologies, Mechanics and Optics

к.м.н., с.н.с. научно-исследовательского отд. артериальной гипертензии, зам. ген. директора по работе с регионами, начальник управления по реализации федеральных проектов, доцент каф. внутренних болезней института медицинского образования ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава России; с.н.с. института трансляционной медицины ФГАОУ ВО «Санкт-Петербургский национальный исследовательский университет информационных технологий, механики и оптики» (Университет ИТМО), ORCID: 0000-0001-6533-5950 Saint-Petersburg, Russia

D I Kurapeev

Federal State Budgetary Institution “V.A. Almazov National Medical Research Center”

к.м.н., зам. ген. директора по информационным технологиям ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава России, ORCID: 0000-0002-2190-1495 Saint-Petersburg, Russia

Yu S Yudina

Federal State Budgetary Institution “V.A. Almazov National Medical Research Center”

м.н.с. научно-исследовательской лаб. патогенеза и терапии артериальной гипертензии научно-исследовательского отд. артериальной гипертензии ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава России, ORCID: 0000-0001-8759-8751 Saint-Petersburg, Russia

A O Konradi

Federal State Budgetary Institution “V.A. Almazov National Medical Research Center”; Saint-Petersburg National Research University of Information Technologies, Mechanics and Optics

д.м.н., проф., член-корр. РАН, зам. ген. директора по научной работе, глава научно-исследовательского отд. артериальной гипертензии ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава России; директор института трансляционной медицины ФГАОУ ВО «Санкт-Петербургский национальный исследовательский университет информационных технологий, механики и оптики» (Университет ИТМО), ORCID: 0000-0001-8169-7812 Saint-Petersburg, Russia

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