进一步改善轻中度高血压治疗施仲伟.ppt

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1、Telemedicine Study进一步改善轻中度高血压治疗上海交通大学医学院附属瑞金医院 施仲伟Home Health Monitoring Reduces Cardiovascular Disease RiskIn Medically Underserved CommunitiesAlfred A. Bove, MD, PhDTemple Univ. Medical SchoolPhiladelphia, PaTelemedicine studyReported on March 30 , 2009 at ACC 2009Objective Lower Cardiovascular Di

2、sease Risk in Urban and Rural Underserved Communities Compare A nurse management program 4 office visits in one year vs.Nurse management plus weekly reporting of CVD risk factors via TelemedicineStudy Subjects Rural and Urban Subjects Framingham risk score 10% No overt CVD Age 2075 Males and Females

3、 Known PCP (Personal Care Provider)Primary End-Point 5% or Greater in CVD Risk at 1 year25% - NM, 37.5% - TStudy Protocol388 Subjects completed the studyOne Year ResultsAmong patients with stage 1 hypertension who used the telemedicine reporting system, SBP reduction was significantly lower.Conclusi

4、ons and Implications A nurse management program can reduce CVD risk in medically underserved communities, However cost for this management is prohibitive Telemedicine provides additional benefit for Blood Pressure management, particularly in patients with mild to moderate HBPImplications Nurse Manag

5、ed CVD risk reduction potentially can significantly reduce CVD morbidity and mortality However cost for this management is prohibitive Telemedicine provides a low cost complementary risk reduction tool Automated reminders via web and telephone PHR for archiving data and providing portability Timely

6、feedback and advice for risk management专家即刻评论“This is one of several studies demonstrating that the combination of some form of Web-based technology plus human intervention is effective in lowering blood pressure.“ Daniel W. Jones, MDpast president of AHADean of Univ MississippiSchool of Medicine http:/ 2008, 299(24):2857-2867

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