Blood pressure management through application-based telehealth platforms: a systematic review and meta-analysis.
Journal
Journal of hypertension
ISSN: 1473-5598
Titre abrégé: J Hypertens
Pays: Netherlands
ID NLM: 8306882
Informations de publication
Date de publication:
01 07 2022
01 07 2022
Historique:
entrez:
28
6
2022
pubmed:
29
6
2022
medline:
30
6
2022
Statut:
ppublish
Résumé
Hypertension management has several challenges, including poor compliance with medications and patients being lost to follow-up. Recently, remote patient monitoring and telehealth technologies have emerged as promising methods of blood pressure management. We aimed to investigate the role of application-based telehealth programs in optimizing blood pressure management. Searches were performed in December 2020 using three databases: Cochrane Central Register of Controlled Trials, Embase and Ovid MEDLINE. All randomized controlled trials that included remote blood pressure management programmes were eligible for inclusion. Studies were included if blood pressure data were available for both the intervention and control groups. Following PRISMA guidelines, data were independently collected by two reviewers. Data were pooled using a random-effects model. The primary study outcomes were mean SBP and DBP changes for the intervention and control groups. Eight hundred and seventy-nine distinct articles were identified and 18 satisfied inclusion and exclusion criteria. Overall, a mean weighted decrease of 7.07 points (SBP) and 5.07 points (DBP) was found for the intervention group, compared with 3.11 point (SBP) and 3.13 point (DBP) decreases in the control group. Forest plots were constructed and effect sizes were also calculated. Mean change effect sizes of 1.1 (SBP) and 0.98 (DBP) were found, representing 86 and 85% of the intervention group having greater SBP or DBP changes, respectively, when compared with the control group. Remote patient monitoring technologies may represent a promising avenue for hypertension management. Future research is needed to evaluate the benefits in different disease-based patient subgroups.
Sections du résumé
BACKGROUND AND OBJECTIVES
Hypertension management has several challenges, including poor compliance with medications and patients being lost to follow-up. Recently, remote patient monitoring and telehealth technologies have emerged as promising methods of blood pressure management. We aimed to investigate the role of application-based telehealth programs in optimizing blood pressure management.
METHODS
Searches were performed in December 2020 using three databases: Cochrane Central Register of Controlled Trials, Embase and Ovid MEDLINE. All randomized controlled trials that included remote blood pressure management programmes were eligible for inclusion. Studies were included if blood pressure data were available for both the intervention and control groups. Following PRISMA guidelines, data were independently collected by two reviewers. Data were pooled using a random-effects model. The primary study outcomes were mean SBP and DBP changes for the intervention and control groups.
RESULTS
Eight hundred and seventy-nine distinct articles were identified and 18 satisfied inclusion and exclusion criteria. Overall, a mean weighted decrease of 7.07 points (SBP) and 5.07 points (DBP) was found for the intervention group, compared with 3.11 point (SBP) and 3.13 point (DBP) decreases in the control group. Forest plots were constructed and effect sizes were also calculated. Mean change effect sizes of 1.1 (SBP) and 0.98 (DBP) were found, representing 86 and 85% of the intervention group having greater SBP or DBP changes, respectively, when compared with the control group.
DISCUSSION
Remote patient monitoring technologies may represent a promising avenue for hypertension management. Future research is needed to evaluate the benefits in different disease-based patient subgroups.
Identifiants
pubmed: 35762467
doi: 10.1097/HJH.0000000000003164
pii: 00004872-202207000-00001
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
1249-1256Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Références
Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol 2020; 16:223–237.
Kirkland EB, Heincelman M, Bishu KG, Schumann SO, Schreiner A, Axon RN, et al. Trends in healthcare expenditures among US adults with hypertension: national estimates, 2003-2014. J Am Heart Assoc 2018; 7:e008731.
Kitagawa K, Yamamoto Y, Arima H, Maeda T, Sunami N, Kanzawa T, et al. Effect of standard vs intensive blood pressure control on the risk of recurrent stroke: a randomized clinical trial and meta-analysis. JAMA Neurol 2019; 76:1309–1318.
Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertens Dallas Tex 19792020; 75:1334–1357.
Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertens Dallas Tex 19792018; 71:1269–1324.
Stupplebeen DA, Pirkle CM, Sentell TL, Nett BMI, Ilagan LSK, Juan B, et al. Self-measured blood pressure monitoring: program planning, implementation, and lessons learned from 5 federally qualified health centers in Hawai’i. Prev Chronic Dis 2020; 17:E47.
Brown Connolly NE. A better way to evaluate remote monitoring programs in chronic disease care: receiver operating characteristic analysis. J Am Telemed Assoc 2014; 20:1143–1149.
Kodama R, Arora S, Anand S, Choudhary A, Weingarten J, Francesco N, et al. Reengineering the discharge transition process of COVID-19 patients using Telemedicine, remote patient monitoring, and around-the-clock remote patient monitoring from the emergency department and inpatient units. Telemed E-Health 2021; 27:1188–1193.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. J Clin Epidemiol 2021; 134:178–189.
Page MJ, Shamseer L, Tricco AC. Registration of systematic reviews in PROSPERO: 30,000 records and counting. Syst Rev 2018; 7:32.
Sani M, Makeen A, Albasheer OBA, Solan YMH, Mahfouz MS. Effect of telemedicine messages integrated with peer group support on glycemic control in type 2 diabetics, Kingdom of Saudi Arabia. Int J Diabetes Dev Ctries 2018; 38:495–501.
Rinfret S, Lussier MT, Peirce A, Duhamel F, Cossette S, Lalonde L, et al. The impact of a multidisciplinary information technology-supported program on blood pressure control in primary care. Circ Cardiovasc Qual Outcomes 2009; 2:170–177.
Logan AG, Irvine MJ, McIsaac WJ, Tisler A, Rossos PG, Easty A, et al. Effect of home blood pressure telemonitoring with self-care support on uncontrolled systolic hypertension in diabetics. Hypertension 2012; 60:51–57.
Bove AA, Homko CJ, Santamore WP, Kashem M, Kerper M, Elliott DJ. Managing hypertension in urban underserved subjects using telemedicine--a clinical trial. Am Heart J 2013; 165:615–621.
Magid DJ, Olson KL, Billups SJ, Wagner NM, Lyons EE, Kroner BA. A pharmacist-led, American Heart Association Heart360 Web-enabled home blood pressure monitoring program. Circ Cardiovasc Qual Outcomes 2013; 6:157–163.
Margolis KL, Asche SE, Bergdall AR, Dehmer SP, Groen SE, Kadrmas HM, et al. Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control: a cluster randomized clinical trial. JAMA 2013; 310:46–56.
McKinstry B, Hanley J, Wild S, Pagliari C, Paterson M, Lewis S, et al. Telemonitoring based service redesign for the management of uncontrolled hypertension: multicentre randomised controlled trial. BMJ 2013; 346:f3030.
McManus RJ, Mant J, Haque MS, Bray EP, Bryan S, Greenfield SM, et al. Effect of self-monitoring and medication self-titration on systolic blood pressure in hypertensive patients at high risk of cardiovascular disease: the TASMIN-SR randomized clinical trial. JAMA 2014; 312:799–808.
Hanley J, Fairbrother P, Krishan A, McCloughan L, Padfield P, Paterson M, et al. Mixed methods feasibility study for a trial of blood pressure telemonitoring for people who have had stroke/transient ischaemic attack (TIA). Trials 2015; 16:117.
Nicolucci A, Cercone S, Chiriatti A, Muscas F, Gensini G. A randomized trial on home telemonitoring for the management of metabolic and cardiovascular risk in patients with Type 2 diabetes. Diabetes Technol Ther 2015; 17:563–570.
Or C, Tao D. A 3-month randomized controlled pilot trial of a patient-centered, computer-based self-monitoring system for the care of Type 2 diabetes mellitus and hypertension. J Med Syst 2016; 40:81.
He J, Irazola V, Mills KT, Poggio R, Beratarrechea A, Dolan J, et al. Effect of a community health worker-led multicomponent intervention on blood pressure control in low-income patients in Argentina: a randomized clinical trial. JAMA 2017; 318:1016–1025.
Cairns AE, Tucker KL, Leeson P, Mackillop LH, Santos M, Velardo C, et al. Self-management of postnatal hypertension: the SNAP-HT Trial. Hypertension 2018; 72:425–432.
Pan F, Wu H, Liu C, Zhang X, Peng W, Wei X, et al. Effects of home telemonitoring on the control of high blood pressure: a randomised control trial in the Fangzhuang Community Health Center, Beijing. Aust J Prim Health 2018; 24:398–403.
Dorje T, Zhao G, Tso K, Wang J, Chen Y, Tsokey L, et al. Smartphone and social media-based cardiac rehabilitation and secondary prevention in China (SMART-CR/SP): a parallel-group, single-blind, randomised controlled trial. Lancet Digit Health 2019; 1:e363–e374.
Li X, Li T, Chen J, Xie Y, An X, Lv Y, et al. A WeChat-based self-management intervention for community middle-aged and elderly adults with hypertension in Guangzhou, China: a cluster-randomized controlled trial. Int J Env Res Public Health 2019; 16. https://www.ncbi.nlm.nih.gov/pubmed/31652688 https://res.mdpi.com/d_attachment/ijerph/ijerph-16-04058/article_deploy/ijerph-16-04058-v2.pdf .
Zheng X, Spatz ES, Bai X, Huo X, Ding Q, Horak P, et al. Effect of text messaging on risk factor management in patients with coronary heart disease: the CHAT Randomized Clinical Trial. Circ Cardiovasc Qual Outcomes 2019; 12:e005616.
Jahan Y, Rahman MM, Faruque ASG, Chisti MJ, Kazawa K, Matsuyama R, et al. Awareness development and usage of mobile health technology among individuals with hypertension in a rural community of Bangladesh: randomized controlled trial. J Med Internet Res 2020; 22:e19137.
Sheppard JP, Tucker KL, Davison WJ, Stevens R, Aekplakorn W, Bosworth HB, et al. Self-monitoring of blood pressure in patients with hypertension-related multimorbidity: systematic review and individual patient data meta-analysis. Am J Hypertens 2020; 33:243–251.
Tucker KL, Sheppard JP, Stevens R, Bosworth HB, Bove A, Bray EP, et al. Self-monitoring of blood pressure in hypertension: a systematic review and individual patient data meta-analysis. PLoS Med 2017; 14:e1002389.
Thangada ND, Garg N, Pandey A, Kumar N. The emerging role of mobile-health applications in the management of hypertension. Curr Cardiol Rep 2018; 20:78.
Thompson AC, Thompson MO, Young DL, Lin RC, Sanislo SR, Moshfeghi DM, et al. Barriers to follow-up and strategies to improve adherence to appointments for care of chronic eye diseases. Invest Ophthalmol Vis Sci 2015; 56:4324–4331.
Andersen G, Christensen D, Kirkevold M, Johnsen SP. Poststroke fatigue and return to work: a 2-year follow-up. Acta Neurol Scand 2012; 125:248–253.
Coute RA, Nathanson BH, Panchal AR, Kurz MC, Haas NL, McNally B, et al. Disability-adjusted life years following adult out-of-hospital cardiac arrest in the United States. Circ Cardiovasc Qual Outcomes 2019; 12:e004677.
Hankey GJ, Jamrozik K, Broadhurst RJ, Forbes S, Anderson CS. Long-term disability after first-ever stroke and related prognostic factors in the Perth Community Stroke Study, 1989–1990. Stroke 2002; 33:1034–1040.