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Table 1 Summary of randomised studies evaluating self-monitoring with telemonitoring or self-management

From: Protocol for a randomised controlled trial of telemonitoring and self-management in the control of hypertension: Telemonitoring and self-management in hypertension. [ISRCTN17585681]

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)