Managing hypertension in urban underserved subjects using telemedicine—A clinical trial

Bové, Alfred A.; Homko, Carol J.; Santamore, William P.; Kashem, Mohammed A.; Kerper, Margaret; Elliott, Daniel

doi:10.1016/j.ahj.2013.01.004

Cited by 70 publications

(106 citation statements)

References 27 publications

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“…Study selection criteria : Studies were included in this review if they: ( 1 ) focused on physicians, both as the consultation requester (solely or with other health care providers) and consultant, ( 2 ) reported a real–not simulated–medical consultation for real patients that occurred between two or more physicians, ( 3 ) published within the recent 10 years, ( 4 ) were in English, and ( 5 ) had an available abstract. Retrieved studies were excluded if they were: ( 1 ) review studies, expert opinions, editorials, or repeated articles from the same authors, or interventions (only the most updated or final version was included), ( 2 ) only a telephone-consultation, and ( 3 ) published only as an abstract (as for a conference proceeding).…”

Section: Methodsmentioning

confidence: 99%

“…Teleconsultation is defined as synchronous or asynchronous consultation using information and communication technology to omit geographical and functional distance. Its goals are for diagnostics or treatment between two or more geographically separated health providers (for example physicians or nurses) or between health providers and patients ( 1 ). “Remote consultation” is the superior term of teleconsultation in MeSH (Medical Subject Headings) and is defined as “Consultation by remote telecommunications, generally for the purpose of diagnosis or treatment of a patient at a site remote from the patient or primary physician”( 2 ).…”

Section: Introductionmentioning

confidence: 99%

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Teleconsultation and Clinical Decision Making: a Systematic Review

2016

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Background:The goal of teleconsultation is to omit geographical and functional distance between two or more geographically separated health care providers. The purpose of present study is to review and analyze physician-physician teleconsultations. Method: The PubMed electronic database was searched. The primary search was done on January 2015 and was updated on December 2015. A fetch and tag plan was designed by the researchers using an online Zotero library. Results: 174 full-text articles of 1702 records met inclusion criteria. Teleconsultation for pediatric patients accounts for 14.36 percent of accepted articles. Surgery and general medicine were the most prevalent medical fields in the adults and pediatrics, respectively. Most teleconsultations were inland experiences (no=135), and the USA, Italy and Australia were the three top countries in this group. Non-specialists health care providers/centers were the dominant group who requested teleconsultation (no=130). Real time, store and forward, and hybrid technologies were used in 50, 31, and 16.7 percent of articles, respectively. The teleconsultation were reported to result in change in treatment plan, referral or evacuation rate, change in diagnosis, educational effects, and rapid decision making. Use of structured or semi-structured template had been noticed only in a very few articles. Conclusion: The present study focused on the recent ten years of published articles on physician-physician teleconsultations. Our findings showed that although there are positive impacts of teleconsultation as improving patient management, still have gaps that need to be repaired.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Teleconsultation and Clinical Decision Making: a Systematic Review

2016

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“…35 Bove's RCT, which evaluated an Internet-and telephone-based telemedicine system for reducing BP in underserved patients diagnosed with hypertension, showed that engaged patients had significantly lower BP with or without telemedicine. 32 Further, as compared to the controls, the telemedicine intervention resulted in a greater reduction in systolic BP for patients with hypertension who did not have diabetes as a comorbid condition. Clearly, there is considerable interest in using technology-assisted interventions but the results for selfmanagement for hypertension control, while very promising, are inconsistent, as Table 2 indicates.…”

Section: Applicability and Efficacy Of Telehealth To Hypertensionmentioning

confidence: 97%

“…31 Bove randomized 241 urban, underserved patients with systolic BP ‡ 140 mm Hg to a telemedicine intervention or usual care, concluding that the intervention may be a useful tool for managing hypertension, particularly among nondiabetic subjects. 32 Carter reported success with home-based use of wireless scales, BP cuffs, and glucometers for patients with diabetes and comorbid conditions. 33 Wakefield's randomized controlled study (RCT) of home telehealth in comorbid hypertension and diabetes found that ''although older patients may not be accustomed to using technology, it doesn't mean they aren't willing to learn.''…”

Section: Applicability and Efficacy Of Telehealth To Hypertensionmentioning

confidence: 98%

Are Telehealth Technologies for Hypertension Care and Self-Management Effective or Simply Risky and Costly?

McKoy

Fitzner

Margetts

et al. 2015

Population Health Management

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Hypertension is a prevalent chronic disease that requires ongoing management and self-care. The disease affects 31% of American adults and contributed to or caused the deaths of 348,000 Americans in 2008, fewer than 50% of whom effectively self-managed the disease. However, self-management is complex, with patients requiring ongoing support and easy access to care. Telehealth may help foster the knowledge and skills necessary for those with hypertension to engage in successful self-management. This paper considers the applicability, efficacy, associated risks, and cost-effectiveness of telehealth for individuals and populations with hypertension. Telehealth is a broad term, encompassing telemedicine and mobile health that is used for physician-patient interactions, diagnostics, care delivery, education, information sharing, monitoring, and reminders. Telemedicine may have considerable utility for people diagnosed with hypertension who have poor access or social barriers that constrain access, but potential risks exist. Telehealth technology is evolving rapidly, even in the absence of fully proven cost-effectiveness and efficacy. Considering the cost of inpatient and emergency department care for patients with hypertension, telehealth is a highly attractive alternative, but there are risks to consider. Incorporating telehealth, which is increasingly characterized by mobile health, can increase both the capacity of health care providers and the reach of patient support, clinical management, and self-care. Telehealth studies need improvement; long-term outcome data on cardiovascular events must be obtained, and robust risk analyses and economic studies are needed to prospectively evaluate the safety and cost savings for hypertension self-management.

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“…[ 5 ] The simplest telecommunication equipment is an ordinary telephone. Conventionally, telemedicine has been popular among cardiology,[ 6 ] ophthalmology,[ 7 ] radiology,[ 8 ] etc., for transfer of videos, images, and other data from remote areas. Telemedicine may also be utilized to facilitate communication between the physician and the patient who are separated by any distance.…”

Section: T He C Hronic N mentioning

confidence: 99%

Telemedicine for diabetes care: An Indian perspective - feasibility and efficacy

Kesavadev

Saboo

Shankar

et al. 2015

Indian J Endocr Metab

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Diabetes is a chronic and costly disease. In India, the usual practice among patients is to visit the doctor once in every 2–3 months to get advice on changes in the dosages of medications. The Diabetes Tele Management System (DTMS®) is a telemedicine based follow-up program originally introduced at Jothydev's Diabetes Research Centre at Trivandrum South India in 1998. It is a chronic disease management system which enables patient to interact lively with a professionally trained multidisciplinary team comprising of diabetes educators, nurses, dieticians, pharmacists, psychologists, physicians, etc., in modifying the dosages of medications, diet, and physical activity either through telephone/email/secure website. The uniquely designed software and the trained multidisciplinary team overcomes the globally recognized major barriers to diabetes management namely fear of hypoglycemia, polypharmacy, discontinuation of stains, and antihypertensives or wrong injection techniques. DTMS is designed to provide individualized therapy advices on glycosylated hemoglobin, blood pressure, and low density lipoprotein customized to multiple patient characteristics which help attain goals of therapy. The system has been tested on various platforms over a decade and was shown to be a patient friendly approach with successful outcomes due to a live “round-the-clock” interactive communication in contrast to text or recorded messages. The major challenge to the widespread use of DTMS® is seeking a source of funding this unique telemedicine program.

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Managing hypertension in urban underserved subjects using telemedicine—A clinical trial

Cited by 70 publications

References 27 publications

Teleconsultation and Clinical Decision Making: a Systematic Review

Teleconsultation and Clinical Decision Making: a Systematic Review

Are Telehealth Technologies for Hypertension Care and Self-Management Effective or Simply Risky and Costly?

Telemedicine for diabetes care: An Indian perspective - feasibility and efficacy

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