PS3-15 THE ROLE OF TELEHOMECARE ON BLOOD PRESSURE CONTROL IN PATIENTS WITH HEART FAILURE AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN ONTARIO, CANADA

Tuesday, June 14, 2016
Exhibition Space (30 Euston Square)
Poster Board # PS3-15

Valeria E. Rac, MD, PhD1, Yeva Sahakyan, MD, MPH2, Lusine Abrahamyan, MD, MPH, PhD1, Nida Shahid, HBSc., MSc (c.)2, Aleksandra Stanimirovic, MSc, PhD (candidate)2, Petros Pechlivanoglou, MSc, PhD2, Welson Ryan2, Nicholas Mitsakakis, MSc PhD1 and Murray Krahn, MD, MSc, FRCPC1, (1)Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto, ON, Canada, (2)Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, ON, Canada
Purpose: The purpose of this study was to investigate the changes in blood pressure (BP) among patients with heart failure (HF) and chronic obstructive pulmonary disease (COPD) enrolled in the Telehomecare program in Ontario.

Method(s): This was a longitudinal cohort study. The outcome of interest was change in biweekly average of systolic and diastolic BP levels over six-month program duration.  Data was extracted from the Ontario Telemedicine Network database from July 2012 to Jul 2015 and analyzed using general linear mixed model procedures in SAS. We conducted a subgroup analysis in patients with uncontrolled BP levels (≥140/90 mm Hg) at baseline.

Result(s): Overall, data for 3513 patients were analyzed. Average age was 74.1±11.4; 62% had HF, 55% had COPD. At baseline, the systolic and diastolic BP were 130.5±19.2 mm Hg and 72.2±12.6 mm Hg. Over 6 month program period, there were 4.0 mm Hg (95% CI: -4.5 to -3.5) and 2.7 mm Hg (95% CI: -3.1 to -2.4) reduction in systolic and diastolic BP respectively, adjusted for confounders. About 35% (n = 1220) of the cohort had uncontrolled BP levels at baseline (150.7 ±10.4 /80.2±13.5 mm Hg). In that subgroup, the reduction in systolic BP was 12.5 mm Hg (95% CI: -13.4 to -11.6) and in diastolic BP was 7.1 mm Hg (95% CI: 7.8 to 6.5) over 6 month period.

Conclusion(s): The changes seen in patients’ BP over time, lead us to interpret that patients with elevated levels of BP may benefit the most from participation in the Telehomecare program.

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