Sehnert Walter, Mengden Thomas
Institut für klinische Forschung Sehnert, IKFS, Clinical Research Institute, Dortmund.
Med Klin (Munich). 2009 Apr 15;104(4):314-22. doi: 10.1007/s00063-009-1053-3.
Telemetric blood pressure measurement opens a new dimension of cooperation between physician and patient. It requires clearly defined therapeutic target values. Telemonitoring is judged positively by 93% of patients treated this way for its exact and long-lasting observation mode by the treating physician. A better control of hypertension is possible due to adaption of therapy over a long observation period and exact blood pressure data by the treating physician and a better adherence to therapy by the patients. Besides good technical and logistic feasibility, published studies show a high acceptance both on the part of patients and treating physicians. Randomized, controlled and prospective studies showed significantly better blood pressure control of telemetrically observed patients compared to standard care. Telemedicine was exceptionally effective when combined with regular individualized interventions like phone calls. These data have to be confirmed by large prospective studies including "hard" endpoints and economic aspects. Of special interest is the telemetric observation in high-risk hypertensive patients like those with coronary artery disease, heart failure, cerebrovascular complications, or hypertension in pregnancy.
遥测血压测量开启了医生与患者合作的新维度。它需要明确界定的治疗目标值。93%接受这种治疗方式的患者对远程监测给予了积极评价,因为治疗医生能够通过其精确且持久的观察模式进行监测。由于在较长观察期内可根据治疗医生获取的精确血压数据调整治疗方案,且患者对治疗的依从性更好,因此有可能更好地控制高血压。除了良好的技术和后勤可行性外,已发表的研究表明患者和治疗医生都高度认可。随机、对照和前瞻性研究表明,与标准护理相比,遥测观察患者的血压控制情况明显更好。当远程医疗与定期的个性化干预(如电话随访)相结合时,效果格外显著。这些数据必须通过包括“硬”终点和经济方面的大型前瞻性研究来证实。特别值得关注的是对高危高血压患者的遥测观察,如患有冠状动脉疾病、心力衰竭、脑血管并发症或妊娠期高血压的患者。