TELEMEDICINE FOR HYPERTENSION MANAGEMENT: THE TELEMED-SI STUDY

Objective: This study evaluates the effectiveness of telemedicine in managing hypertensive patients compared to standard outpatient care, focusing on blood pressure reduction over a 12-week period. Design and method: A prospective, ongoing clinical trial was designed to include patients aged 18 years or more with hypertension (BP 140/90 mmHg or more) taking 4 or less antihypertensive drugs. Patients were randomized into two groups: the telemedicine group (TM group), receiving remote BP monitoring and therapy adjustments via a telemedicine algorithm, and the standard care group, receiving routine outpatient management. 68 patients were allocated to the TM group and 29 to the standard care group. An interim analysis after 12 weeks assessed changes in systolic and diastolic blood pressure (SBP and DBP) from baseline using a repeated measures mixed model. Statistical tests confirmed baseline balance between groups. Results: SBP and DBP showed significant reductions over 12 weeks, with mean reductions of 7.2 mmHg (0.598 mmHg/week, p < 0.0001) and 3.8 mmHg (0.323 mmHg/week, p < 0.0001), respectively. No significant differences in BP reduction were observed between groups (difference: 2.08 mmHg, p = 0.373), indicating both approaches were similarly effective. Nine patients from the TM group withdrew, citing the time-consuming nature of frequent BP measurement as part of telemedicine management. Conclusions: The interim analysis demonstrates that telemedicine and standard outpatient care are equally effective in reducing BP in hypertensive patients. However, telemedicine placed additional strain on healthcare providers due to limited human resources, a significant challenge in our setting. While telemedicine may benefit certain patient populations, further research is needed to identify the conditions and resources required to maximize its potential.