Table 1 Summary of randomised studies evaluating self-monitoring with telemonitoring or self-management
Study | Number of subjects Mean age Length of follow up | Type & frequency of BP self measurement | Frequency of other input (either as co-intervention or outcome measurement) | Was physician adjusting medication aware of self measurement readings | Outcome measurement | Outcome of study |
|---|---|---|---|---|---|---|
Friedman 1996 US [11] | 267 patients under care of community physicians Age 77 6 months | Automated Weekly (?upper arm) | Self report of BP, adherence etc via computerised telephone system (TLC) on a weekly basis with automated feedback | "TLC" data transmitted to patient's own physician | BP measured on home visit; protocol for measurement not clear if blinded | Small drop in DBP only after adjustment (mean adjusted DBP change 5.2 mmHg vs 0.8 mmHg, No CIs, p = 0.02) |
Mehos [13] 2000 US | 36 primary care patients with poorly controlled hypertension 59 years 6 months | Manual electronic Daily Upper arm | Monthly telephone calls to coordinate treatment changes All received counselling on ht rx and lifestyle | Yes | not clear if blinded | No CI s or p quoted |
Rogers [12] 2001 US | 121 hypertensive patients from hospital clinic 61 years At least 8 weeks | Automated 3 days per week (? upper arm) | Transmission of results of BP down phone line Monthly reports to patient and physician electronically generated | Yes | Main outcome ambulatory BP monitoring pre and post intervention which physicians were blinded to | Reduction in MAP of 3 mmHg, (no CI, p = 0.013) |
Artinian [14] 2001 US | 26 African American with hypertension attending a family community centre | Automated At least 3 days per week Upper arm | Transmission of BP results down phone line each Friday with automated feedback to patients Additional feedback via study nurse | Yes | Clinic measurement before and after measured by blinded investigator | Pilot study: no formal comparison of between group BP drop. |
Zarnke [15] 1997 Canada | 31 hypertensive primary care patients 55 years 8 weeks | Electronic Twice daily (?upper arm) | Self directed adjustment of medication Self help advice to all | Yes if consulted when patient had already tried to change treatment | Mercury sphyg; not clear if blinded but externally measured. Also ambulatory BP | Intervention group had lower mean ambulatory MAP.(-0.95 vs +1.9 mmHg, No CI, p = 0.039) |