Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review.
| Autor: | Hoffer-Hawlik M; Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States of America.; Resolve to Save Lives, an initiative of Vital Strategies, New York, New York, United States of America., Moran A; Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States of America.; Resolve to Save Lives, an initiative of Vital Strategies, New York, New York, United States of America., Zerihun L; Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States of America., Usseglio J; Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States of America., Cohn J; Resolve to Save Lives, an initiative of Vital Strategies, New York, New York, United States of America.; Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America., Gupta R; Resolve to Save Lives, an initiative of Vital Strategies, New York, New York, United States of America.; Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, United States of America. |
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| Jazyk: | angličtina |
| Zdroj: | PloS one [PLoS One] 2021 Jul 09; Vol. 16 (7), pp. e0254222. Date of Electronic Publication: 2021 Jul 09 (Print Publication: 2021). |
| DOI: | 10.1371/journal.pone.0254222 |
| Abstrakt: | Hypertension remains the leading cause of cardiovascular disease worldwide and disproportionately impacts patients living in low- and middle-income countries (LMICs). Telemedicine offers a potential solution for improving access to health care for vulnerable patients in LMICs. Objectives: The purpose of this scoping review was to summarize the evidence for telemedicine interventions for blood pressure management in LMICs and assess the relationships between the telemedicine intervention characteristics and clinical outcomes. Design: Published studies were identified from the following databases (from their inception to May 2020): PubMed, Scopus, and Embase. Search terms related to "Low and Middle Income Countries," "Telemedicine," and "Hypertension" were used, and clinical outcomes were extracted from the screened articles. Results: Our search resulted in 530 unique articles, and 14 studies were included in this review. Five studies assessed telemedicine interventions for patient-provider behavioral counseling, four assessed patient-provider medical management, and five assessed provider-provider consultation technologies. Out of fourteen individual studies, eleven demonstrated a significant improvement in systolic or diastolic blood pressure in the intervention group. Of the eight studies that reported difference-in-differences changes in systolic blood pressure, between-arm differences ranged from 13.2 mmHg to 0.4 mmHg. Conclusions: The majority of the studies in this review demonstrated a significant reduction in blood pressure with use of the telemedicine intervention, though the magnitude of benefit was not consistently large. Limitations of the studies included small sample sizes, short duration, and intervention heterogeneity. Current evidence suggests that telemedicine may provide a promising approach to increase access to care and improve outcomes for hypertension in LMICs, especially during events that limit access to in-person care, such as the COVID-19 pandemic. However, high-quality clinical trials of sufficient size and duration are needed to establish the impact and role of telemedicine in hypertension care. The protocol for this review was not registered. Competing Interests: The authors have declared that no competing interests exist. |
| Databáze: | MEDLINE |
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