Efficacy of Telemedicine in Hypertension Care through Home Blood Pressure Monitoring and Video Conferencing: Paradigm of Antihypertensive Therapy Along with Telemedicine Randomized (POATRAND) Trial Report.

Abstract

BACKGROUND\nThe burden of time is often the primary reason why patients discontinue their treatment. Telemedicine (TM) may help patients adhere to treatment by offering convenience.\n\n\nOBJECTIVE\nThis study examined the efficacy and safety of TM for the management of hypertension in Japan.\n\n\nMETHODS\nPatients with uncomplicated hypertension were recruited through web advertising between November 2015 and February 2017. They were then screened, stratified by office systolic blood pressure (SBP), and randomized into two groups: usual care (UC) and TM. The TM group used a 3G network-attached home blood pressure (BP) monitoring device, consulted hypertension specialists from academic hospital through virtual video visits, and received prescription medication by mail for 1 year. The UC group used the same BP monitoring device but was managed using self-recorded BP readings, such as their diary entries, and office BP taken in community practice setting.\n\n\nRESULTS\nInitial screening was completed by 99 patients, 54% of whom had untreated hypertension. Baseline BP was similar between the groups, but the weekly average SBP at the end of the 1-year study period was significantly lower in the TM group (125\uf0b19 vs. 131\uf0b112 mmHg, P = .02). SBP in the TM group was 3.4 mmHg lower in the morning and 5.8 mmHg lower in the evening. The rate of SBP control (\uf03c135 mmHg) was better in the TM group (85.3% vs. 70.0%, P = .01), and significant adverse events were not observed.\n\n\nCONCLUSIONS\nWe present evidence suggesting that antihypertensive therapy via home BP telemonitoring and virtual video visits achieves better BP control compared with conventional care. It proves to be a safe treatment alternative and should thus be further investigated.\n\n\nCLINICALTRIAL\nUMIN Clinical Trials Registry No. UMIN000025372; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000029170.