Abstract

Aim. To study the effectiveness and benefits of blood pressure (BP) remote monitoring in outpatients with hypertension.Material and methods. The study included 100 patients with a verified diagnosis of hypertension, who didn’t achieve target BP pressure levels. The patients measured their BP twice a day over 6 months with facilities with automatic data transmission over GSM-channel to a remote monitoring center. BP parameters were being transmitted online to the remote monitoring center, where they were being processed and transferred to the personal account planner (created by the Web interface based on the software and hardware complex) of the attending physician and operator of the remote monitoring center. It is important that doctor received information only on clinically significant measurement results, based on which he determined the urgency of contact with the patient and the further tactics of his management.Results. No malfunctions in the work of communication facilities, technical failures in the software and hardware complex were registered over the entire period of the study. After 6 months of the monitoring it was possible to achieve target BP levels less than 135/85 mm Hg in 70% of patients. The proportion of patients with a high level of normal BP increased from 10% to 19%, while the proportion of patients with grade 1 and 2 of hypertension decreased significantly (from 33% to 7% and from 54% to 3%, respectively). At the beginning of telemedicine monitoring 3% of patients had stage 3 of hypertension, at the end of the study – 1%.Conclusion. The technology of telemedicine monitoring has shown itself as a simple, affordable and reliable way of management of outpatients with hypertension in conditions of real clinical practice. It was possible to achieve BP levels less than 135/85 mm Hg in 70% of patients by the method of remote outpatient monitoring. BP remote monitoring changed fundamentally the decision-making strategy of the patients management: it was not the patient who independently determined the need for consultation with a medical professional, but the attending physician made a decision on the method and urgency of contact with the patient on the basis of the data of objective monitoring indicators.

Highlights

  • The proportion of patients with a high level of normal blood pressure (BP) increased from 10% to 19%, while the proportion of patients with grade 1 and 2 of hypertension decreased significantly

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  • Сведения об авторах: Аксенова Наталья Викторовна – врач-терапевт, ГКБ No11 Низов Алексей Александрович – д.м.н., профессор, зав. кафедрой внутренних болезней, Рязанский ГМУ Селявина Ольга Николаевна – зам. главного врача по амбулаторно-поликлинической помощи, ГКБ No 11; ассистент, кафедра экономики, права и управления здравоохранением, Рязанский ГМУ Сучкова Екатерина Игоревна – врач-терапевт, ГКБ No11; аспирант, кафедра внутренних болезней, Рязанский ГМУ Филиппов Евгений Владимирович – д.м.н., профессор, зав. кафедрой поликлинической терапии и профилактической медицины, Рязанский ГМУ

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Summary

Blood Pressure Remote Monitoring Дистанционный мониторинг артериального давления

Развитие и прогрессирование сердечно-сосудистых заболеваний наиболее тесно связано с образом жизни больных и высокой распространенностью факторов риска [1,2]. Наиболее значимыми причинами недостаточного контроля АД признаны низкая приверженность больных к лечению, нерегулярность или отсутствие контактов пациента с лечащим врачом и нерациональная система организации медицинской помощи [2,6]. С целью повышения эффективности антигипертензивной терапии на территории РФ и ряда других стран изучаются возможности дистанционного (телемедицинского) мониторинга АД. Телемедицинские технологии существенно повышают эффективность антигипертензивной терапии и приверженность больных к лечению благодаря регулярным контактам пациента с врачом, в том числе, и с помощью телефонной связи [6,7,8]. Наиболее целесообразно внедрение телемедицинского наблюдения за параметрами АД в регионах РФ с высоким уровнем сердечно-сосудистой заболеваемости и смертности, в число которых входит и Рязанская область [9].

Материал и методы
Категории АД
Findings
Other AHD Прочие АГП
Full Text
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