Mileski Michael, Kruse Clemens Scott, Catalani Justin, Haderer Tara
School of Health Administration, Texas State University, San Marcos, TX, United States.
JMIR Med Inform. 2017 Oct 24;5(4):e41. doi: 10.2196/medinform.6603.
Hypertension is a chronic condition that affects adults of all ages. In the United States, 1 in 3 adults has hypertension, and about half of the hypertensive population is adequately controlled. This costs the nation US $46 billion each year in health care services and medications required for treatment and missed workdays. Finding easier ways of managing this condition is key to successful treatment.
A solution to reduce visits to physicians for chronic conditions is to utilize telemedicine. Research is limited on the effects of utilizing telemedicine in health care facilities. There are potential benefits for implementing telemedicine programs with patients dealing with chronic conditions. The purpose of this review was to weigh the facilitators against the barriers for implementing telemedicine.
Searches were methodically conducted in the Cumulative Index to Nursing and Allied Health Literature Complete (CINAHL Complete) via Elton B Stephens Company (EBSCO) and PubMed (which queries MEDLINE) to collect information about self-management of hypertension through the use of telemedicine.
Results identify facilitators and barriers corresponding to the implementation of self-management of hypertension using telemedicine. The most common facilitators include increased access, increase in health and quality, patient knowledge and involvement, technology growth with remote monitoring, cost-effectiveness, and increased convenience/ease. The most prevalent barriers include lack of evidence, self-management difficult to maintain, no long-term results/more areas to address, and long-term added workload commitment.
This review guides health care professionals in incorporating new practices and identifying the best methods to introduce telemedicine into their practices. Understanding the facilitators and barriers to implementation is important, as is understanding how these factors will impact a successful implementation of telemedicine in the area of self-management of hypertension.
高血压是一种影响各年龄段成年人的慢性疾病。在美国，三分之一的成年人患有高血压，且约一半的高血压患者得到了充分控制。这每年给美国造成460亿美元的医疗保健服务、治疗所需药物以及旷工方面的损失。找到更简便的管理这种疾病的方法是成功治疗的关键。
减少慢性病患者看医生次数的一个解决方案是利用远程医疗。关于在医疗机构中使用远程医疗的效果的研究有限。对患有慢性病的患者实施远程医疗项目有潜在益处。本综述的目的是权衡实施远程医疗的促进因素和障碍。
通过艾尔顿·B·斯蒂芬斯公司（EBSCO）在护理及联合健康文献累积索引完整版（CINAHL Complete）以及通过查询医学文献数据库（MEDLINE）的PubMed中系统地进行检索，以收集有关通过使用远程医疗进行高血压自我管理方面的信息。
结果确定了与使用远程医疗进行高血压自我管理实施情况相对应的促进因素和障碍。最常见 的促进因素包括可及性增加、健康状况和质量改善、患者知识和参与度提高、远程监测技术发展、成本效益以及便利性/易用性增加。最普遍的障碍包括缺乏证据、自我管理难以维持、没有长期结果/更多需要解决的领域以及长期增加的工作量投入。
本综述指导医疗保健专业人员采用新做法并确定将远程医疗引入其实践的最佳方法。了解实施的促进因素和障碍很重要，了解这些因素将如何影响远程医疗在高血压自我管理领域的成功实施也很重要。
