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Increasing Awareness And Control Of Blood Pressure By Computer-Based Ring Calls

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A simple, automated feedback system made hypertension patients added aware of their potentially fatal or disabling disease and helped them significantly lower their elevated blood pressure, according to a report published in Circulation: Cardiovascular Quality and Outcomes.
In a one-year study, the computer-based operation telephoned participants at least once a week and a voice-recognition programme asked for the most new blood coercion reading they had recorded at home. The information was automatically relayed to patients' physicians and pharmacists, who could intervene provided a reading indicated problems.
"This system worked as efficaciously as if we had added a dissimilar medication on top of the patients' other medications," said Pavel Hamet, M.D., Ph.D., senior author of the scan and professor of medicine, physiology and nutrition at the University of Montreal in Canada. Among researchers' key findings:
  • At the trial's end, 24-hour monitoring showed an average reduction of 11.9 millimeters of mercury (mm Hg) in systolic blood impulse and 6.6 mm Hg in diastolic pressure for the intervention group versus reductions of 7.1 mm Hg systolic and 4.5 mm Hg diastolic for the control patients. "That was just chunk of the gold-standard verification that the system worked," Hamet said.
  • Blood power readings measured in physicians' offices averaged reductions of 18.7 mm Hg for systolic and 9.1 mm Hg for diastolic among intervention patients compared to reductions of 13.8 mm Hg and 5.6 mm Hg for the management group.
  • Augmented intervention patients met the U.S. and Canadian definition for controlled blood vigour (less than 140/90 mm Hg), 46 percent versus 28.6 percent of the controls.
  • Physicians treating the intervention association were also likely to add drugs or augmentation medication dosage. At the study's end, intervention patients were captivating an guideline of two classes of antihypertensive drugs compared to one for the state group.
The researchers recruited 223 hypertension patients through 21 physicians at eight primary chagrin clinics in Laval, Quebec, near Montreal. All patients had 24-hour blood energy recordings fictional with portable monitors they wore. Then, 111 were assigned to the intervention battery and 112 to the authority group.
Intervention patients received an educational booklet, a digital down home blood compel monitor, a log book and access to the telephone-linked management system. Charge patients received the booklet and their accepted medical care.
Hamet attributes the study's success to the regular feedback that the intervention patients received. "Something was telling them how beefy they were doing," he said. "For example, the system alerted pharmacists when patients had not picked up their prescription refills on time."
The team did not conception the glance at to determine if one organization suffered fewer strokes or other hypertension-related complications. However, 14 (12.6 percent) of the intervention participants and eight (7.1 percent) of the controls were hospitalized during the study, both nonsignificant differences.
"The automated blood-pressure control course could be widely popular if it's cost-effective. The healthcare system doesn't want to increase the valuation without some benefit," Hamet said.
The trial bunch is designing a health economics announce to better assess the cost of the program. Additional medications, the automated development and home monitors add costs, "but whether you can prevent stroke or kidney damage, which are besides costly complications of hypertension, it should be economically sound," Hamet said.
Co-authors are: Stephane Rinfret, M.D.; Marie-Therese Lussier, M.D.; Anthony Peirce, M.Sc.; Fabie Duhamel, Ph.D.; Sylvie Cossette, Ph.D.; Lyne Lalonde, Ph.D.; Chantal Tremblay, R.N.; Marie-Claude Guertin, Ph.D.; Jacques LeLorier, M.D., Ph.D.; and Jacques Turgeon, Ph.D. Individual author disclosures can be institute on the manuscript.
The study was funded by Pfizer Canada, Inc., the Canadian Institutes of Health Research and Fonds de recherch√ en sante du Quebec.
Karen Astle
American Heart Association
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