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Cited by 68Blood Pressure and Hypertension StudiesTelemedicine and Telehealth ImplementationMobile Health and mHealth Applications

Self-Measurement and Self-Titration in HypertensionA Pilot Telemedicine Study

BOBRIE, G, POSTELVINAY, N, DELONCA, J, CORVOL, P·2007·American Journal of Hypertension
DOI 10.1016/j.amjhyper.2007.08.011
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Abstract

BACKGROUND: Because of poor patient compliance and clinical inertia, hypertension control rates remain poor. Home blood-pressure measurements (HBPM) improve compliance of patients and achievement of blood pressure (BP) targets. However, few studies have evaluated self-BP management by patients. METHODS: In a multicenter, prospective, single-group, open-label pilot study of 111 patients whose hypertension was uncontrolled despite monotherapy, we studied satisfaction with, and feasibility of, HBPM and self-titration of antihypertensive treatment using telemedicine for compliance, efficacy, and safety. After education (protocol, action plan, and use of the HBPM device), patients performed a sequence of HBPM every 2 weeks for 8 weeks. Following a stepwise approach, treatment was increased by the patient at weeks 4 and 6 if average HBPM values exceeded predefined limits. For each titration, the patient informed the Core Center by telemedicine, but BP values were transferred automatically. RESULTS: Overall, 80% of patients were satisfied (58%) or very satisfied (23%) with the program (95% confidence interval, 73% to 87%). Regarding compliance, 78% of patients fully complied with self-measurement, and just over 71% titrated their treatment adequately. Physicians were satisfied (52%) or very satisfied (22%) with the program. Between the first and final visits (at week 8), office systolic/diastolic BP (mean +/- SD) decreased significantly from 151 +/- 9/91 +/- 6 to 143 +/- 13/84 +/- 11 mmHg. During the trial, HBPM (mean +/- SD) decreased significantly from 149 +/- 13/86 +/- 12 to 138 +/- 16/81 +/- 10 mmHg. No significant safety issues were reported. CONCLUSIONS: This innovative approach to the management of hypertension, combining self-measurement and self-titration, is feasible, well-accepted by both patients and physicians, and safe.

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Authors
BOBRIE, G., POSTELVINAY, N., DELONCA, J., & CORVOL, P.
Affiliations
  • Hôpital Européen Georges-Pompidou (FR)
  • Bristol-Myers Squibb (France) (FR)
Corresponding author
BOBRIE, G
Venue
American Journal of Hypertension
Publisher
Oxford University Press (OUP)
Published
2007-12
Volume
20
Issue
12
Pages
1314-1320
ISSN
0895-7061 (ISSN-L)
DOI
10.1016/j.amjhyper.2007.08.011
OpenAlex
W2024198186
Cited by
68
References
27
Citations by year
2025: 3 · 2024: 1 · 2021: 2 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 7 · 2014: 4 · 2013: 4 · 2012: 9
FWCI
3.99
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
hypertension, home blood pressure monitoring, self-titration, telemedicine, antihypertensive therapy, medication adherence, uncontrolled hypertension, patient satisfaction, physician satisfaction, blood pressure control
MeSH terms
Aged, Blood Pressure Determination, Female, Humans, Hypertension, Male, Middle Aged, Patient Compliance, Pilot Projects, Prospective Studies, Self Care, Telemedicine

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