Internet-based care aids blood pressure control

NEW YORK (Reuters Health) - Advice and medications delivered via the internet, along with home blood pressure (BP) monitoring, lets people with high blood pressure get their condition under control, researchers have report in this week's Journal of the American Medical Association.

Dr. Beverly B. Green, at the University of Washington in Seattle, and colleagues tested whether high blood pressure could be managed over the Internet without the need for visits to a doctor.

"Our demographic was middle-aged, working people for whom Web-based care is particularly convenient, particularly for reporting BP numbers and simple or structured communications," Green told Reuters Health.

The clinical trial included 778 patients with uncontrolled high blood pressure and internet access. They were randomly assigned to usual care, or to home BP monitoring and Web services training, or to home monitoring, Web services training, and management by a pharmacist delivered through Internet communications.

The Web services permitted patients to email their doctors, refill prescriptions, request appointments, get test results, and look up health information.

The pharmacists in the study were allowed to prescribe medications and they managed the patients' blood pressure using email communication to adjust medications until the target blood pressure was reached.

After 12 months, about one-third of the patients in the first two groups achieved a normal blood pressure. However, with the Internet-based pharmacist care, more than half the patients got their blood pressure down to normal.

"Web communication (e-mail and secure messaging) improves health care because it is always available (24/7), allows people to respond at a time that is convenient to them, and often in a much briefer way than over the telephone or certainly during an in-person visit," Green pointed out.

"We believe that greater use of electronic medical records, Web communications, and empowering patients to take a greater role in their care will lead to improved health outcomes and will decrease health care costs," she added. "More efforts need to be taken to make these services available to all."

In future research, she and her associates plan to apply their strategy to other chronic conditions, such as diabetes.

SOURCE: Journal of the American Medical Association, June 25, 2008.