远程监测高血压患者:在少数群体中进行临床试点的可行性和结果
Michael Makutonin1, Justin Dare2, Mary Heekin1
1The George Washington University, Washington, DC, USA.
Journal of primary care & community health
|October 10, 2023
概括
远程患者监测 (RPM) 在低SES,少数群体中有效管理高血压,显示不劣血压控制和更少的诊所访问. 指出了患者合规和付款人拒绝等实施挑战.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 高血压影响了48%的美国成年人,每年直接成本超过1300亿美元.
- 远程患者监测 (RPM) 对高血压治疗有希望,但其在少数,低SES人群中的成本效益尚未研究.
- 这项研究解决了评估RPM临床和财务结果的必要性,主要是少数群体,低SES人口.
研究的目的:
- 评估RPM在高风险人口中高血压管理的临床有效性.
- 评估实施高血压护理RPM的财务可行性和成本效益.
- 在服务不足的社区中确定RPM采用障碍和促进者的障碍.
主要方法:
- 一项前性队列试点研究,涉及患有失控初级高血压的患者.
- 患者通过手和传输枢纽每天接受血压监测,每周进行随访电话.
- 与299名患者的对照组进行了比较,使用了回顾性图表数据.
主要成果:
- 在90天后,RPM干预组 (13名患者) 与对照组相比,表现出非劣势的血压控制 (46%与31%,P=.33).
- 在RPM组中观察到办公室访问的显著减少 (1.5对5.9次访问,P<.001).
- 该计划在90天内为每名患者带来了29美元的适度财务利,并指出了实施障碍.
结论:
- 在少数,医疗补助主导的队列中,RPM实现了非劣势的血压控制,并显著减少了临床访问.
- 尽管有临床益处,但该计划的收入很少,这凸显了患者合规性和付款人退款方面的挑战.
- 需要进一步的研究来优化RPM的实施,并克服在弱势群体中广泛采用的障碍.
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