Treatment Intensification in a Hypertension Telemanagement Trial
| Autor: | Hayden B. Bosworth, Maren K. Olsen, Benjamin J. Powers, Valerie Smith, Susanne Danus, Matthew J Crowley, Eugene Z. Oddone |
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| Rok vydání: | 2011 |
| Předmět: | |
| Zdroj: | Hypertension. 58:552-558 |
| ISSN: | 1524-4563 0194-911X |
| DOI: | 10.1161/hypertensionaha.111.174367 |
| Popis: | Clinical inertia represents a barrier to hypertension management. As part of a hypertension telemanagement trial designed to overcome clinical inertia, we evaluated study physician reactions to elevated home blood pressures. We studied 296 patients from the Hypertension Intervention Nurse Telemedicine Study who received telemonitoring and study physician medication management. When a patient's 2-week mean home blood pressure was elevated, an “intervention alert” prompted study physicians to consider treatment intensification. We examined treatment intensification rates and subsequent blood pressure control. Patients generated 1216 intervention alerts during the 18-month intervention. Of 922 eligible intervention alerts, study physicians intensified treatment in 374 (40.6%). Study physician perception that home blood pressure was acceptable was the most common rationale for nonintensification (53.7%). When “blood pressure acceptable” was the reason for not intensifying treatment, the mean blood pressure was lower than for intervention alerts where treatment intensification occurred (135.3/76.7 versus 143.2/80.6 mm Hg; P |
| Databáze: | OpenAIRE |
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