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