関連する実験動画
高血圧のコントロールにおけるテレモニタリングと自己管理 (TASMINH2):ランダム化制御試験
Richard J McManus1, Jonathan Mant, Emma P Bray
1Primary Care Clinical Sciences, University of Birmingham and National Institute for Health Research (NIHR) National School for Primary Care Research, Birmingham, UK. r.j.mcmanus@bham.ac.uk
Lancet (London, England)
|July 13, 2010
まとめ
家庭での血圧モニタリングとテレモニタリングを含む高血圧の自己管理は,通常のケアと比較して患者の血圧制御を大幅に改善しました. このアプローチは,プライマリケア環境における高血圧管理のための貴重な新しい戦略を提供します.
科学分野:
- 心血管医学は,心臓血管医学である.
- 公衆衛生は公衆衛生である.
- 医療サービス 研究 医療サービス
背景:
- 効果的な血圧管理は,心血管疾患の予防に不可欠ですが,達成することはしばしば困難です.
- 歴史的に,高血圧管理は主に医療従事者によって主導されてきた.
研究 の 目的:
- 通常のケアと比較して,自己モニタリングとテレモニタリングを含む高血圧の患者自己管理の有効性を評価する.
- 自己管理が,不十分な高血圧のコントロールを持つ個体において,よりよい血圧制御につながるかどうかを判断する.
主な方法:
- イギリスの24の総合診療所で,高血圧 (BP > 140/90 mm Hg) の527人の患者 (35歳から85歳) を対象としたランダム化制御試験.
- 参加者は,自己管理グループ (自己モニタリング,自己タイトリング,テレモニタリング) または通常のケアグループに1:1でランダムに割り当てられました.
- 主なエンドポイントは,6ヶ月と12ヶ月で平均シストリック血圧の変化でした.
主要な成果:
- 自己管理グループでは,通常治療グループと比較して6ヶ月 (12.9 mm Hg vs 9.2 mm Hg) と12ヶ月 (17.6 mm Hg vs 12.2 mm Hg) でシストリック血圧がより大きく低下しました.
- グループ間の静脈性血圧低下の違いは,両方の時点において統計的に有意であった (p=0.013 6ヶ月で,p=0.0004 12ヶ月で).
- 足の腫れは,通常のケアグループ (22%) よりも,自己管理グループ (32%) でより頻繁に報告されました.
結論:
- 遠隔モニタリングによって強化された高血圧の患者の自己管理は,初等医療における血圧制御を改善するための効果的な戦略です.
- このアプローチは,高血圧の管理における重要な進歩であり,患者に権限を与え,潜在的に心血管疾患のアウトカムを改善します.
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