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Disease Management & Health Outcomes

, Volume 15, Issue 1, pp 19–31 | Cite as

Hypertension Home Telemonitoring

Current Evidence and Recommendations for Future Studies
  • Mirou Jaana
  • Guy Paré
  • Claude Sicotte
Review Article

Abstract

Home telemonitoring is a patient-management approach that allows timely data transfer and immediate feedback. With the large number of people experiencing hypertension worldwide and the burden of this medical condition, home blood pressure (BP) telemonitoring has become popular given its potential for reducing cost and improving patient care. This study provides an overview on the current evidence and trends of hypertension telemonitoring, and presents recommendations for future studies in this area.

A comprehensive literature search was conducted from 1966 to 2006 on Cochrane Library, ScienceDirect, PubMed, MEDLINE, EMBASE, CINAHL, and PsycINFO using the key words ‘hypertension’, ‘blood pressure’, ‘telemonitoring’, ‘telecare’, ‘telemedicine’, ‘biotelemetry’, ‘telehealth’, and ‘telehomecare’. Fourteen studies involving telemonitoring experiments were found and included in this review, ten of which were conducted in Europe and the US. The studies present evidence on the positive impacts of telemonitoring on patients and their conditions (e.g. significant BP control, better medication adherence, changes in patients’ lifestyle). However, the results of the studies should be considered with caution due to the limitations of study designs. Furthermore, little is known about the effects of telemonitoring on services utilization and only one study demonstrated a detailed cost-effectiveness analysis of this approach.

This review presents preliminary evidence on the benefits of telemonitoring as a successful patient-management approach. However, at present, limited information exists that would substantiate its effects on the utilization of health services (e.g. office and emergency room visits, hospitalizations) and demonstrate its economic viability. Future studies should examine the effects of mediating variables and the mechanisms through which BP control is achieved. Further research should also incorporate designs that allow more control and investigate its effects over longer time periods with larger diversified samples of patients.

Keywords

Diastolic Blood Pressure Usual Care Blood Pressure Control Blood Pressure Measurement African American Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

References

  1. 1.
    Louis A, Turner T, Gretton M, et al. A systematic review of telemonitoring for the management of heart failure. Eur J Heart Fail 2003; 5: 583–90PubMedCrossRefGoogle Scholar
  2. 2.
    Farmer A, Gibson OJ, Tarassenko L, et al. A systematic review of telemedicine interventions to support blood glucose self-monitoring in diabetes. Diabet Med 2005; 22: 1372–8PubMedCrossRefGoogle Scholar
  3. 3.
    Meystre S. The current state of telemonitoring: a comment on the literature. Telemed J E Health 2005; 11(1): 63–9PubMedCrossRefGoogle Scholar
  4. 4.
    Pickering TG, Gerin W, Holland JK. Home blood pressure teletransmission for better diagnosis and treatment. Curr Hypertens Rep 1999; 1: 489–94PubMedCrossRefGoogle Scholar
  5. 5.
    Chobanian AV, Bakris JL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42: 1206–52PubMedCrossRefGoogle Scholar
  6. 6.
    World Health Organization. Chronic disease risk factors [online]. Available from URL: http://www.who.int/dietphysicalactivity/publications/facts/riskfactors/en/ [Accessed 2006 Jul 27]
  7. 7.
    Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA 2003; 290(2): 199–206PubMedCrossRefGoogle Scholar
  8. 8.
    L’hypertension au Canada [online]. Available from URL: http://www.passeportsante.net/fr/Actualites/Satistiques/Fiche.aspx?.doc=hypertension_canada_20-06_st [Accessed 2006 May 9]
  9. 9.
    Mengden T, Vetter H, Tisler A, et al. Tele-monitoring of home blood pressure. Blood Press Monit 2001; 6: 185–9PubMedCrossRefGoogle Scholar
  10. 10.
    Nakamoto H, Nishida E, Ryuzaki M, et al. Blood pressure monitoring by cellular telephone in patients on continuous ambulatory peritoneal dialysis. Adv Perit Dial 2004; 20: 105–10PubMedGoogle Scholar
  11. 11.
    Artinian NT, Washington OGM, Klymko KW, et al. What you need to know about home blood pressure. Home Healthc Nurse 2004; 22(10): 680–6PubMedCrossRefGoogle Scholar
  12. 12.
    Bai J, Zhang Y, Dai B, et al. The design and preliminary evaluation of a home electrocardiography and blood pressure monitoring network. J Telemed Telecare 1996; 2: 100–6PubMedCrossRefGoogle Scholar
  13. 13.
    Zhang Y, Bai J, Zhou X, et al. First trial of home ECG and blood pressure telemonitoring system in Macau. Telemed J 1997; 3(1): 67–72PubMedCrossRefGoogle Scholar
  14. 14.
    Denolle T, Weber JL, Calvez C, et al. Home blood pressure measured telemetrically in hypertensive pregnant women [abstract]. Am J Hypertens 2001; 14 (4 Pt 2): 42AGoogle Scholar
  15. 15.
    Mansoor GA, White WB. Trans-telephonic home blood pressure strongly correlates to ambulatory blood pressure but is significantly lower than awake values [abstract]. Am J Hypertens 2001; 14 (4 Pt 2): 21ACrossRefGoogle Scholar
  16. 16.
    Zarnke KB, Feagan BG, Mahon JL, et al. A randomized study comparing a patient-directed hypertension management strategy with usual office-based care. Am J Hypertens 1997; 10: 58–67PubMedCrossRefGoogle Scholar
  17. 17.
    Cappuccio FP, Kerry SM, Forbes L, et al. Blood pressure control by home monitoring: meta-analysis of randomized trials. BMJ 2004; 329: 145–51PubMedCrossRefGoogle Scholar
  18. 18.
    Friedman RH, Kazis LE, Jette A, et al. A telecommunications system for monitoring and counselling patients with hypertension: impact on medication adherence and blood pressure control. Am J Hypertens 1996; 9: 285–92PubMedCrossRefGoogle Scholar
  19. 19.
    Rogers MAM, Small D, Buchan DA, et al. Home monitoring service improves mean arterial pressure in patients with essential hypertension. Ann Intern Med 2001; 134: 1024–32PubMedGoogle Scholar
  20. 20.
    Artinian NT, Washington OGM, Templin TN. Effects of home telemonitoring and community-based monitoring on blood pressure control in urban African Americans: a pilot study. Heart Lung 2001; 30: 191–9PubMedCrossRefGoogle Scholar
  21. 21.
    Bondmass M, Bolger N, Castro G, et al. The effect of home monitoring and telemanagement on blood pressure control among African Americans. Telemed J 2000; 6(1): 15–23CrossRefGoogle Scholar
  22. 22.
    Naef RW, Perry KG, Magann EF, et al. Home blood pressure monitoring for pregnant patients with hypertension. J Perinatol 1998; 18(3): 226–9PubMedGoogle Scholar
  23. 23.
    Mengden T, Ewald S, Kaufmann S, et al. Telemonitoring of blood pressure self measurement in the OLMETEL study. Blood Press Monit 2004; 9: 321–5PubMedCrossRefGoogle Scholar
  24. 24.
    Port K, Palm K, Viigimaa M. Daily usage and efficiency of remote home monitoring in hypertensive patients over a one-year period. J Telemed Telecare 2005; 11 Suppl. 1: 34–6PubMedCrossRefGoogle Scholar
  25. 25.
    Roth A, Golovner M, Malov N, et al. The “telepress” system for self-measurement and monitoring of blood pressure (the “Shahal” experience in Israel). Am J Cardiol 1999; 83: 610–2PubMedCrossRefGoogle Scholar
  26. 26.
    Aris IB, Wagie AAE, Mariun NB, et al. An Internet-based blood pressure monitoring system for patients. J Telemed Telecare 2001; 7: 51–3PubMedCrossRefGoogle Scholar
  27. 27.
    Moller DS, Dideriksen A, Sorensen S, et al. Tele-monitoring of home blood pressure in treated hypertensive patients. Blood Press 2003; 12: 56–62PubMedGoogle Scholar
  28. 28.
    Port K, Palm K, Viigimaa M. Self-reported compliance of patients receiving antihypertensive treatment: use of a telemonitoring home care system. J Telemed Telecare 2003; 9 Suppl. 1: 65–6CrossRefGoogle Scholar
  29. 29.
    Nakajima K, Nambu M, Kiryu T, et al. Low-cost, e-mail based system for self blood pressure monitoring at home. J Telemed Telecare 2006; 12: 203–7PubMedCrossRefGoogle Scholar
  30. 30.
    Ménard J, Linhart A, Weber JL, et al. Teletransmission and computer analysis of self-blood pressure measurements at home. Blood Press Monit 1996; 1 Suppl. 2: S63–7Google Scholar
  31. 31.
    Ewald S, Esche J, Uen S, et al. Relationship between the frequency of blood pressure self-measurement and blood pressure reduction with antihypertensive therapy: results of the OLMETEL (OLMEsartan TELemonitoring blood pressure) study. Clin Drug Invest 2006; 26(8): 439–46CrossRefGoogle Scholar
  32. 32.
    Asmar R, Zanchetti A. Guidelines for the use of self-blood pressure monitoring: a summary report of the first international consensus conference. J Hypertens 2000; 18: 493–508PubMedCrossRefGoogle Scholar
  33. 33.
    Parati G, Bilo G, Mancia G. Blood pressure measurement in research and in clinical practice: recent evidence. Curr Opin Nephrol Hypertens 2004; 13: 343–57PubMedCrossRefGoogle Scholar
  34. 34.
    Rogers MAM. Using telemedicine for patients with hypertension. Cardiol Rev 2001; 19(1): 38–41Google Scholar
  35. 35.
    Finkelstein SM, Snyder M, Edin-Stibbe C, et al. Monitoring progress after lung transplantation from home-patient adherence. J Med Eng Technol 1996; 20(6): 203–10PubMedCrossRefGoogle Scholar
  36. 36.
    Morlion B, Knoop C, Paiva M, et al. Internet-based home monitoring of pulmonary function after lung transplantation. Am J Respir Crit Care Med 2002; 165: 694–7PubMedGoogle Scholar
  37. 37.
    Steel S, Lock S, Johnson N, et al. A feasibility study of remote monitoring of asthmatic patients. J Telemed Telecare 2002; 8(5): 290–6PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2007

Authors and Affiliations

  • Mirou Jaana
    • 1
  • Guy Paré
    • 1
  • Claude Sicotte
    • 2
  1. 1.HEC MontréalMontrealCanada
  2. 2.Department of Health AdministrationUniversity of MontrealMontrealCanada

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