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

Ionov, M.; Жукова, О. В.; Звартау, Надежда; Курапеев, Д. И.; Yudina, Yu. S.; Конради, А. О.

doi:10.26442/00403660.2020.01.000481

Cited by 3 publications

(3 citation statements)

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“…ранее нами сообщены результаты клинической эффективности телемониторирования аД и ТМ-дистанционного консультирования (ТМДк) у пациентов с неконтролируемой неосложненной аГ, в том числе с применением методик атрибутивной статистики [13]. Однако с точки зрения современных представлений об экономике здравоохранения параллельная и совместная оценка отдаленных клинических и пациентоориентированных результатов лечения становится базисом для высокоинформативного и показательного экономического анализа, результирующего затраты на определенное количество сохраненных лет качественной жизни [14].…”

Section: ââåäåíèåunclassified

“…Рандомизированное клиническое исследование в основу моделирования легли данные, полученные в результате проведенного трехмесячного рандомизированного исследования [13]. его участниками стали 240 пациентов Сведения об авторах: Жукова Ольга Вячеславовна -к.ф.н., доц.…”

Section: ìàòåðèàëû è ìåòîäûunclassified

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Blood pressure telemonitoring and remote counseling in uncontrolled hypertension

Ionov¹,

Жукова²,

Звартау³

et al. 2021

Terapevticheskii arkhiv

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Telehealth is a useful adjunct in hypertension (HTN) management. Despite obvious short-term clinical benefit, long-term social impact and cost-effectiveness have not been fully investigated. Aim. Predictive modeling of long-term clinical and social outcomes and the cost-effectiveness analysis of blood pressure (BP) telemonitoring and remote counseling (BPTM) in patients with HTN. Materials and methods. A Markov cohort-based (1000 patients in each study arm) model was developed and adopted a 10-year time horizon with 12-month time cycles. Cost and outcome data collected from the three-month study of 240 patients (160 in BPTM group and 80 controls, 48 y.o.). All patients started at a non-complicated HTN well state with a certain possibility of disease progression in a number of health states over a discrete time period. BPTM was compared with usual care in terms of 10-year healthcare costs, quality adjusted life years (QALY) using a Ministry of Health of Russian Federation perspective. Results. In the long-term run when compared with usual care BPTM was more effective in terms mortality (67 versus 91 patients lost and 9.6 versus 9.71 life years gained) and costs (cost of illness 102 508 000 RUR versus 145 237 700 RUR). Taking quality of life measures into account, the effect of BPTM was also more pronounced (8.31 versus 7.82 QALYs gained). The resultant incremental cost-utility ratio for BPTM was 275 178.98 RUR/1 QALY gained/1 patient (134 837.70 RUR/0.49 QALY/1 patient). Conclusion. According to the results of predictive modeling, implementation of BPTM into clinical practice is likely lead to reduced cardiovascular morbidity and mortality in a cost-effective way.

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Section: ìàòåðèàëû è ìåòîäûunclassified

Blood pressure telemonitoring and remote counseling in uncontrolled hypertension

Ionov¹,

Жукова²,

Звартау³

et al. 2021

Terapevticheskii arkhiv

View full text Add to dashboard Cite

show abstract

“…На основании полученных данных ТМАД в ФГБУ "НМИЦ им. В. А. Алмазова" (240 пациентов) был рассчитан показатель популяционной атрибутивной эффективности, который указывает на то, что применение ТМАД увеличивает вероятность достижения целевых показателей АД в представленной популяции пациентов на 36,7% (95% ДИ [24,1; 49,2]) [55]. Кроме того, на макроэкономическом уровне Олейников В. Э. и др.…”

Section: отсутствие истинной оценки "жестких" конечных точекunclassified

Blood pressure telemonitoring and remote counseling of hypertensive patients: pros and cons

et al. 2020

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Home blood pressure monitoring (HBPM) is strongly recommended by current guidelines as an effective out-of-office diagnostic and monitoring tool in patients with hypertension (HTN). However, there are personal, cultural, logistic difficulties owing to low effectiveness of HBPM. These put HBPM at a disadvantage in routine clinical practice. As such, telehealth solutions are of special interest nowadays, particularly blood pressure telemonitoring (BPTM) with or without remote counseling. BPTM might become something of digital assistant in the long-term patients’ follow-up and it fits well into the practice of continuity of medical care. The purpose of this review is to highlight not only the benefits of BPTM, but important discrepancies that may impede its widespread implementation in everyday clinical work. Critical comments address the lack of long-term, high-quality studies, absence of hard clinical outcomes and uncertainty on the best technical performance.

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Integrated solution for very high cardiovascular risk patients. Rationale and design of a pilot study

et al. 2021

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Coronary artery disease (CAD) is the most common cardiovascular disease and the leading cause of morbidity and mortality. Acute coronary syndrome (ACS) as an abrupt destabilization of CAD, multiplies the risk of cardiovascular events. To reduce the incidence of recurrent cardiovascular events, timely tackling potentially reversible risk factors such as hypertension and/or hyperglycemia is imperative. However, a solid basis for a secondary prevention lies in the treatment of dyslipidemia and begins in the first hours of hospital admission. Despite considerable evidence regarding the efficacy and safety of lipid-lowering therapy, averagely only one third of patients maintain control of lipids. The main challenges are low adherence, poor continuity of medical care, and the lack of an ambulatory routine follow-up. Telehealth solutions are believed to address these barriers and may be considered as an add-on to in-person patient care. Telemonitoring of vital and laboratory parameters, remote patient counseling can be introduced into routine care delivery. Telemedicine shows promise for fostering better clinical effect, and provides health-related quality of life improvement.It is planned to conduct a pilot observational study aimed to create and to test an integrated solution, i.e. telemonitoring and remote counseling in patients of very high cardiovascular risk with ACS followed by myocardial revascularization. The goal is to determine the clinical effectiveness, i.e achievement of target values of blood pressure, lipid profile and glycemia, and patient-centeredness of this approach.

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

Cited by 3 publications

References 37 publications

Blood pressure telemonitoring and remote counseling in uncontrolled hypertension

Blood pressure telemonitoring and remote counseling in uncontrolled hypertension

Blood pressure telemonitoring and remote counseling of hypertensive patients: pros and cons

Integrated solution for very high cardiovascular risk patients. Rationale and design of a pilot study

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