*Futurum - the Academy of Healthcare, Jönköping County Council, Jönköping, Sweden.
J Telemed Telecare. 2009;15(8):397-403. doi: 10.1258/jtt.2009.090509.
We evaluated the feasibility and quality of uncomplicated hypertension care based on telemedicine in a rural area of northern Sweden. The intervention subjects were 91 consecutive patients with primary hypertension. For comparison, 182 age- and sex-matched patients with hypertension were randomly selected from a similar health centre. The telemedicine equipment consisted of a video link between the physician and the patients, supported by a system for accessing medical data via the Internet. During a 21-month study period, telemedicine was used in 270 (91%) of the 297 consultations in the intervention group. All health personnel involved in the telemedicine treatment rated the method as feasible. Both systolic and diastolic blood pressure improved in the two groups during the study period. In the intervention group, a higher proportion had their blood pressure within treatment goals (systolic blood pressure <140 mmHg, diastolic blood pressure <90 mmHg) both at baseline and at follow-up than in the comparison group. An adjusted multivariate model (adjustment for sex, age, time between visits, change in number of drugs between first and last visit, blood pressure at first visit) showed that the intervention group had a higher probability (OR 2.7, 95% CI 1.4-5.2) of reaching the target blood pressure levels than the reference group. Treatment of hypertension by means of telemedicine was quite feasible and at least as effective as face-to-face consultations with a physician.
我们评估了基于远程医疗在瑞典北部农村地区进行简单高血压护理的可行性和质量。干预组为 91 例原发性高血压连续患者。为了比较，从类似的健康中心随机选择了 182 例年龄和性别匹配的高血压患者。远程医疗设备包括医生和患者之间的视频链接，并通过互联网访问医疗数据的系统提供支持。在 21 个月的研究期间，干预组的 297 次咨询中有 270 次（91%）使用了远程医疗。所有参与远程医疗治疗的卫生人员都认为该方法是可行的。在研究期间，两组的收缩压和舒张压均有所改善。在干预组中，与对照组相比，更多的患者在基线和随访时的血压达到治疗目标（收缩压<140mmHg，舒张压<90mmHg）。调整后的多变量模型（调整性别、年龄、就诊时间间隔、首次就诊和末次就诊之间药物数量的变化、首次就诊时的血压）显示，干预组达到目标血压水平的可能性高于参考组（OR 2.7，95%CI 1.4-5.2）。通过远程医疗治疗高血压相当可行，至少与与医生面对面就诊一样有效。
