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Home + pharmacist BP telemonitoring found successful

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Home-based HT management clearly superior

Given the "consistent and substantial" evidence obtained in this and other studies, it is clear that moving hypertension care out of the office and into patients’ homes is safe and effective, said Dr. David J. Magid and Dr. Beverly B. Green.

Yet home-based HT management has not been widely adopted in the United States and isn’t likely to be, unless the current system of reimbursement and performance measurement is changed. Medical insurance must cover patients’ costs for BP telemonitors and reimburse providers for their related services. And home BP must be included in quality assurance assessments of HT care.

"If home BP monitoring and team-based care were implemented broadly, hypertension management would be easier for patients, and the magnitude of BP reductions ... could lead to substantial reductions in cardiovascular events and mortality," they said.

Dr. Magid is at Kaiser Permanente Colorado Institute for Health Research, Denver. Dr. Green is at Group Health Research Institute at the University of Washington, Seattle. They reported no financial conflicts of interest. These remarks were taken from their editorial accompanying Dr. Margolis’s report (JAMA 2013;310:40-1).


 

FROM JAMA

"We conclude that BP telemonitoring and pharmacist case-management was safe and effective for improving BP control compared with usual care during 12 months; and improved BP in the intervention group was maintained for 6 months following the intervention," they said.

"We plan future analyses that will take into account indirect costs during 18 months and long-term cost savings from averting hypertension-related events," they added.

No relevant financial conflicts of interest were reported. HealthPartners Institute for Education and Research has entered a royalty-bearing license agreement to commercialize a simulated learning technology for the purpose of broader dissemination.

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