Randomized clinical trial to assess the effectiveness of remote patient monitoring and physician care in reducing office blood pressure
Randomized clinical trial to assess the effectiveness of remote patient monitoring and physician care in reducing office blood pressure
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DOI：
10.1038/hr.2015.32
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发表时间：
2015-07-01
影响因子：
5.4
通讯作者：
Lee, Chang Hee
中科院分区：
文献类型：
--
作者：
Kim, Yoon-Nyun;Shin, Dong Gu;Lee, Chang Hee
远程患者监测和医生护理对高血压治疗的有效性尚未在随机临床试验中得到证实。本研究的目的是评估有或没有远程医生护理的远程患者监测在降低高血压患者办公室血压方面的有效性。将374例20岁以上的高血压患者随机分为以下3组：对照组(1)接受常规临床护理，家庭血压监测；组(2)远程监测，办公室随访；另一组(3)患者在没有医生办公室护理的情况下，使用远程监护装置进行远程监护。每组每8周随访一次，随访24周。主要终点是24周随访时坐位收缩压的差异。在主要终点上，三组之间没有观察到差异(调整后的平均坐位收缩压如下：1组：-8.9 +/- 15.5 mm Hg， 2组：-11.3 +/- 15.9 mm Hg， 3组：-11.6 +/- 19.8 mm Hg, （NS）。第1组和第2组在随访第24周达到目标血压方面有显著差异。55岁以上受试者的调整后平均坐位收缩压2组和3组与对照组相比有显著降低。在高血压患者中，单独远程监测或远程监测与远程医生护理相结合，在降低血压方面与通常的办公室护理一样有效，且安全性和有效性相当。
The effectiveness of remote patient monitoring and physician care for the treatment of hypertension has not been demonstrated in a randomized clinical trial. The objective of this study was to evaluate the effectiveness of remote patient monitoring with or without remote physician care in reducing office blood pressure in patients with hypertension. A total of 374 hypertensive patients over 20 years of age were randomized into the following three groups: group (1) control, the patients received usual clinical care with home BP monitoring; group (2) the patients were remotely monitored and received office follow-up; and group (3) the patients received remote monitoring without physician office care using the remote monitoring device. For each group, in-office follow-up care was scheduled every 8 weeks for 24 weeks. The primary end point was the difference in sitting SBP at the 24-week follow-up. No difference between the three groups was observed in the primary end point (adjusted mean sitting SBP was as follows: group 1: -8.9 +/- 15.5 mm Hg, group 2: -11.3 +/- 15.9 mm Hg, group 3: -11.6 +/- 19.8 mm Hg, (NS). Significant differences in achieving the target BP at the 24th week of follow-up were observed between groups 1 and 2. The subjects over 55-years old had a significant decrease in the adjusted mean sitting SBP in groups 2 and 3 compared with that of the control group. Remote monitoring alone or remote monitoring coupled with remote physician care was as efficacious as the usual office care for reducing blood pressure with comparable safety and efficacy in hypertensive patients.