Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Cardiology, 8(1), 12. https://doi.org/10.1001/jamacardio.2022.4018 Dr. Alexander Blood et al
Points
- The management of cholesterol and hypertension is still tricky. Beyond the typical in-patient setting, distant care can provide more successful therapy, but scaling and maintaining access to care for various groups can be challenging.
- The primary factors which were measured in the trial were fluctuations in blood pressure and the levels of low-density lipoprotein levels.
Summary
The primary objective of this trial was to determine whether or not high blood pressure and high cholesterol programs run entirely remotely and dispersed across a diverse health network contribute to ensuring adequate healthcare access. The trial also aimed to examine the efficacy of a remotely working high blood pressure and fat control approach across a diverse healthcare network, as well as its implementation and evaluation.
Between January 2018 and July 2021, a comprehensive medical network serving 20,454 patients was evaluated. Three thousand six hundred fifty-eight (3,658) participants had hypertension, 8 103 had elevated cholesterol levels, and 958 had both conditions. One thousand two hundred sixty-six (1,266) participants were asked to receive only education and were not given any medications. The recruited patients received instruction, the installation of a digital blood pressure monitor at home, and medication titration. Unlicensed navigators and pharmacists managed treatment using standardized methods, task automation, and monitoring tools with the assistance of cardiac specialists. Blood pressure and laboratory test results were closely monitored.
Before enrolling in the hypertension program, the average individual’s blood pressure was 150/83 mm Hg, and the average blood pressure at home was 145/83 mm Hg. Six and twelve months after enrollment, the average blood pressure of outpatients who participated in remote medication therapy decreased by 8.7/3.8 and 9.9/5.2 mm Hg, respectively. In the learning-only cohort, the average changes in blood pressure were 1.5/0.7 and +0.2/1.9 mm Hg, respectively.
In this cohort study of 10,803 individuals with blood pressure and cholesterol levels outside of the suggested ranges, remote medication titration administration reduced hypertension and bad cholesterol levels in comparison to education alone. Diverse ethnic, regional, and primary language groups exhibited comparable enrollment rates as well as a decline in blood pressure and low-density lipoprotein cholesterol levels.
These findings indicate that digitally-enabled remote care systems can successfully treat a variety of populations with metabolic disorders. These results suggest that a standardized remote hypertension and lipid monitoring program could eliminate the need for in-person appointments across multiple groups, reduce the risk of cardiovascular disease, and maximize framework-directed medication to a great extent.
Link to the article: https://jamanetwork.com/journals/jamacardiology/article-abstract/2798467
References Blood, A. J., Cannon, C. P., Gordon, W. J., Mailly, C., MacLean, T., Subramaniam, S., Tucci, M., Crossen, J., Nichols, H., Wagholikar, K. B., Zelle, D., McPartlin, M., Matta, L. S., Oates, M., Aronson, S., Murphy, S., Landman, A., Fisher, N. D. L., Gaziano, T. A., … Scirica, B. M. (2023). Results of a remotely delivered hypertension and lipid program in more than 10 000 patients across a diverse health care network. JAMA Cardiology, 8(1), 12. https://doi.org/10.1001/jamacardio.2022.4018
