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Möglichkeiten der Telemedizin bei Hochdruckpatienten

Possibilities of Telemedicine in Arterial Hypertension

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Zusammenfassung

Die Teleblutdruckmessung eröffnet eine neue Dimension der Zusammenarbeit in der Therapie zwischen Behandler und Behandeltem. Ein klar definiertes Ziel der Hochdrucktherapie ist Voraussetzung der gemeinsamen Arbeit zum Erreichen einer Therapievereinbarung. Das Telemonitoring wird wegen der genauen und langfristigen Überwachungsmöglichkeit, der Zeitersparnis für den Patienten und der schnellen Interventionsmöglichkeit durch den Arzt von 93% der so Behandelten positiv bewertet.

Ursachen der besseren Blutdruckkontrolle bei telemedizinisch überwachten Patienten sind die bessere Therapieanpassung an den über lange Beobachtungsperioden gemessenen und exakt dokumentierten Blutdruck durch den behandelnden Arzt und eine bessere Therapieadhärenz des Patienten.

Die bislang publizierten Studien zeigen neben der technischen und logistischen Machbarkeit eine hohe Akzeptanz sowohl bei Patienten als auch bei behandelnden Ärzten. Randomisierte, kontrollierte, prospektive Untersuchungen gaben eindeutige Hinweise, dass telemedizinisch überwachte Patienten eine bessere Blutdruckeinstellung als Patienten unter Standardbetreuung aufweisen. Besonders wirksam war die Telemedizin, wenn sie von regelmäßigen, individualisierten Interventionen, z.B. in Form von Telefonanrufen, begleitet war.

Diese Daten bedürfen einer weiteren Erhärtung durch große, prospektive Untersuchungen unter Einschluss von harten Endpunkten sowie ökonomischen Aspekten. Ein besonderes Interesse der telemedizinischen Blutdrucküberwachung gilt hierbei Hochrisikopatienten z.B. mit koronarer Herzerkrankung, Herzinsuffizienz, zerebrovaskulärer Insuffizienz oder Schwangerschaftshypertonie.

Abstract

Telemetric blood pressure measurement opens a new dimension of cooperation between physician and patient. It requires clearly defined therapeutic target values. Telemonitoring is judged positively by 93% of patients treated this way for its exact and long-lasting observation mode by the treating physician.

A better control of hypertension is possible due to adaption of therapy over a long observation period and exact blood pressure data by the treating physician and a better adherence to therapy by the patients.

Besides good technical and logistic feasibility, published studies show a high acceptance both on the part of patients and treating physicians. Randomized, controlled and prospective studies showed significantly better blood pressure control of telemetrically observed patients compared to standard care. Telemedicine was exceptionally effective when combined with regular individualized interventions like phone calls.

These data have to be confirmed by large prospective studies including “hard” endpoints and economic aspects. Of special interest is the telemetric observation in high-risk hypertensive patients like those with coronary artery disease, heart failure, cerebrovascular complications, or hypertension in pregnancy.

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Authors and Affiliations

  1. Institut für klinische Forschung Sehnert, IKFS, Clinical Research Institute, Dortmund, Germany

    Walter Sehnert

  2. Abteilung Hypertensiologie und Angiologie, Medizinische Universitätsklinik und Poliklinik II, Bonn, Germany

    Thomas Mengden

  3. Institut für klinische Forschung Sehnert, IKFS, Clinical Research Institute, Wittekindstraße 30, 44139, Dortmund, Germany

    Walter Sehnert

  4. Abteilung Hypertensiologie und Angiologie, Medizinische Universitätsklinik und Poliklinik II, Wilhelmstraße 35–37, 53111, Bonn, Germany

    Thomas Mengden

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  2. Thomas Mengden
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Correspondence to Walter Sehnert or Thomas Mengden.

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Sehnert, W., Mengden, T. Möglichkeiten der Telemedizin bei Hochdruckpatienten. Med Klin 104, 314–322 (2009). https://doi.org/10.1007/s00063-009-1053-3

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