Preview

Rational Pharmacotherapy in Cardiology

Advanced search

Prospects for Blood Pressure Remote Monitoring in Hypertensive Patients in the Ryazan Region

https://doi.org/10.20996/1819-6446-2019-15-6-795-801

Full Text:

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.

About the Authors

N. V. Aksenova
City Clinical Hospital №11
Russian Federation

Natalia V. Aksenova – MD, Therapist

Novoselov ul. 26/17, Ryazan, 390037



A. A. Nizov
Ryazan State Medical University named after Academician I.P. Pavlov
Russian Federation

Alexey A. Nizov – MD, PhD, Professor, Head of Chair of Internal Medicine

Vysokovoltnaya ul. 9, Ryazan, 390026



O. N. Selyavina
City Clinical Hospital №11; Ryazan State Medical University named after Academician I.P. Pavlov
Russian Federation

Olga N. Selyavina – MD, Deputy Chief Physician for Outpatient Care, City Clinical Hospital №11; Assistant, Chair of Economics, Law and Healthcare Management, Ryazan State Medical University named after Academician I.P. Pavlov

Novoselov ul. 26/17, Ryazan, 390037, 

Vysokovoltnaya ul. 9, Ryazan, 390026



E. I. Suchkova
City Clinical Hospital №11; Ryazan State Medical University named after Academician I.P. Pavlov
Russian Federation

Ekaterina I. Suchkova – MD, Therapist, City Clinical Hospital №11; Postgraduate Student, Chair of Internal Medicine, Ryazan State Medical University named after Academician I.P. Pavlov

Novoselov ul. 26/17, Ryazan, 390037, 

Vysokovoltnaya ul. 9, Ryazan, 390026



E. V. Filippov
Ryazan State Medical University named after Academician I.P. Pavlov
Russian Federation

Evgenii V. Filippov – MD, PhD, Professor, Head of Chair of Outpatient Therapy and Preventive Medicine

Vysokovoltnaya ul. 9, Ryazan, 390026



References

1. Boytsov S.A., Pogosova N.V., Bubnova M.G., et al. Cardiovascular prevention 2017. National guidelines. Russ J Cardiol. 2018; 23(6):7-122 (In Russ.) DOI:10.15829/1560-4071-2018-6-7122.

2. Yakushin S.S., Filippov E.V. The main directions of the primary prevention of cardiovascular disease. Eruditio Juvenium. 2014;4:55-67 (In Russ.)

3. Boytsov S.A. Balanova Y.A., Shalnova S.A., et al. Arterial hypertension among individuals of 25-64 years old: prevalence, awareness, treatment and control. By the data from ECCD. Cardiovascular Therapy and Prevention. 2014;13(4):4-14 (In Russ.) DOI:10.15829/1728-8800-2014-4-4-14.

4. Boytsov S.A., Yakushin S.S., Martsevich S.Y., et al. Outpatient register of cardiovascular diseases in the Ryazan Region (RECVASA): principal tasks, experience of development and first results. Rational Pharmacotherapy in Cardiology. 2013;9(1):4-14 (In Russ.) DOI:10.20996/1819-6446-2013-9-1-4-14.

5. Filatova T.E, Nizov A.A., Davydov V.V. Experience of treatment of male hypertension with obesity, fasting hyperglycemia and deficiency of vitamin D. I P Pavlov Russian Medical Biological Herald. 2017;25(1):69-75 (In Russ.) DOI:10.23888/PAVLOVJ2017169-75.

6. Boytsov S.A. Realities and prospects of remote blood pressure monitoring in hypertensive patient. Terapevticheskii Arkhiv. 2018;90(1):4-8 (In Russ.) DOI:10.17116/terarkh20189014-8.

7. Duan Y., Xie Z., Dong F., et al. Effectiveness of home blood pressure telemonitoring: a systematic review and meta-analysis of randomised controlled studies. Journal of Human Hypertension. 2017;31(7):427. DOI:10.1038/jhh.2016.99.

8. Mileski M., Kruse C.S., Catalani J., et al. Adopting Telemedicine for the Self-Management of Hypertension: Systematic Review. JMIR Med Inform. 2017;5(4):e41. DOI:10.2196/medinform.6603.

9. Collection of statistical materials on circulatory diseases. Statistical reference. Moscow: Minzdrav Rossii; 2017 (In Russ.)

10. The protocol for the introduction of remote dispensary observation on a limited contingent of patients with arterial hypertension using OMI. Moscow.: GNICPM; 2017 (In Russ.)

11. Boytsov S.А., Komkov D.S., Val'denberg A.V., et al. Method of conducting remote dispensary observation (2016). Appendix to the Guidelines “Dispensary observation of patients with chronic noncommunicable diseases and patients with a high risk of their development” [cited by Oct 05, 2019]. Available from: http://org.gnicpm.ru/wp-content/uploads/2019/01/Metodika_DDN_vers-21.pdf (In Russ.)


For citation:


Aksenova N.V., Nizov A.A., Selyavina O.N., Suchkova E.I., Filippov E.V. Prospects for Blood Pressure Remote Monitoring in Hypertensive Patients in the Ryazan Region. Rational Pharmacotherapy in Cardiology. 2019;15(6):795-801. (In Russ.) https://doi.org/10.20996/1819-6446-2019-15-6-795-801

Views: 124


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)