Mobile phone-based remote patient monitoring system for management of hypertension in diabetic patients
Mobile phone-based remote patient monitoring system for management of hypertension in diabetic patients
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DOI：
10.1016/j.amjhyper.2007.03.020
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发表时间：
2007-09-01
影响因子：
3.2
通讯作者：
Cafazzo, Joseph A.
中科院分区：
文献类型：
--
作者：
Logan, Alexander G.;McIsaac, Warren J.;Cafazzo, Joseph A.
背景：人们对高血压患者血压 (BP) 控制水平不佳的日益关注促使人们寻找治疗高血压的新方法。本研究的目标是开发和试点测试家庭血压远程管理系统，该系统可让患者积极参与护理过程。方法：第一阶段涉及与患者和初级保健提供者举行的一系列焦点小组会议，以指导系统的开发。在第 2 阶段，33 名患有不受控制的动态高血压的糖尿病患者参加了一项为期 4 个月的试点研究，采用前后设计来评估其降低血压的有效性、用户的可接受性以及家庭血压测量的可靠性。 结果：该系统使用商品硬件开发，包括支持蓝牙的家庭血压监测仪、用于接收和传输数据的手机、数据中央服务器 处理、发送医生端口的传真返回系统以及血压警报系统。在试点研究中，24 小时动态血压下降了 11/5 (+/- 13/7 SD) mm Hg（均 P < .001），血压控制显着改善。根据预设的监控计划，服务器收到的家庭读数远远多于预期。在发送给患者的 42 条血压警报中，几乎一半 (n = 20) 是由于低血压引起的。医生没有收到严重血压警报。患者认为该系统是可接受且有效的。结论：这项研究的令人鼓舞的结果为长期、随机、临床试验提供了强有力的理由，以确定这种家庭血压远程管理系统是否可以改善社区中未受控制的高血压患者的血压控制。
Background: Rising concern over the poor level of blood-pressure (BP) control among hypertensive patients has prompted searches for novel ways of managing hypertension. The objectives of this study were to develop and pilot-test a home BP tele-management system that actively engages patients in the process of care.Methods: Phase 1 involved a series of focus-group meetings with patients and primary care providers to guide the system's development. In Phase 2, 33 diabetic patients with uncontrolled ambulatory hypertension were enrolled in a 4-month pilot study, using a before-and-after design to assess its effectiveness in lowering BP, its acceptability to users, and the reliability of home BP measurements.Results: The system, developed using commodity hardware, comprised a Bluetooth-enabled home BP monitor, a mobile phone to receive and transmit data, a central server for data processing, a fax-back system to send physicians' ports, and a BP alerting system. In the pilot study, 24-h ambulatory BP fell by 11/5 (+/- 13/7 SD) mm Hg (both P < .001), and BP control improved significantly. Substantially more home readings were received by the server than expected, based on the preset monitoring schedule. Of 42 BP alerts sent to patients, almost half (n = 20) were due to low BP. Physicians received no critical BP alerts. Patients perceived the system as acceptable and effective.Conclusions: The encouraging results of this study provide a strong rationale for a long-term, randomized, clinical trial to determine whether this home BP tele-management system improves BP control in the community among patients with uncontrolled hypertension.