Telemonitoring and self-management for digital hypertension management: is there a preferred method?

Area of Science:

• Cardiovascular Health
• Digital Health Interventions
• Health Management

Background:

• Telemonitoring and self-management are increasingly used for blood pressure (BP) control.
• Direct comparisons of their efficiency and cost-effectiveness are lacking.
• Both approaches have been compared to standard in-office BP management.

Purpose of the Study:

• To review the current evidence on the advantages and disadvantages of telemonitoring versus self-management for BP control.
• To explore the potential for these approaches to complement each other.

Main Methods:

• Review of existing meta-analyses and studies comparing telemonitoring and self-management to standard care.
• Analysis of cost-effectiveness and healthcare professional workload implications.
• Consideration of patient-provider relationship dynamics.

Main Results:

• Telemonitoring shows faster BP reduction and higher target achievement rates than standard care.
• Digital health interventions (e.g., SMS, apps) improve BP more than usual care, but with high variability.
• Evidence for self-management is less compelling, but some tools are less costly and reduce HCP workload.
• Telemonitoring may increase HCP workload and costs, while self-management reduces it.
• Patient and HCP expectations regarding autonomy and monitoring require further understanding.

Conclusions:

• Neither telemonitoring nor self-management is definitively superior; they have different strengths and weaknesses.
• Telemonitoring and self-management may complement each other in managing blood pressure.
• The 2023 European Society of Hypertension guidelines endorse digital interventions and self-titration.