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血压远程监测和远程医疗在高血压管理中的应用-拉丁美洲从业者的立场、期望和可行性。由美洲多个心脏病学和高血压学会进行的调查。

Blood pressure telemonitoring and telemedicine for hypertension management-positions, expectations and feasibility of Latin-American practitioners. SURVEY carried out by several cardiology and hypertension societies of the Americas.

机构信息

British Sanatorium, Rosario, Argentina.

Mexico Institute of Cardiovascular Health, Mexico City, Mexico.

出版信息

Blood Press. 2022 Dec;31(1):236-244. doi: 10.1080/08037051.2022.2123781.


DOI:10.1080/08037051.2022.2123781
PMID:36123802
Abstract

PURPOSE: To assess the opinion of Latin-American physicians on remote blood pressure monitoring and telehealth for hypertension management. MATERIAL AND METHODS: Cross-sectional survey of physicians residing in Latin-America. The study was conducted by the Mexico Hypertension Experts Group, Interamerican Society of Hypertension, Interamerican Society of Cardiology Epidemiology and Cardiovascular Prevention Council, and National Cardiologist Association of Mexico. An online survey composed of 40 questions using Google Forms was distributed from 7 December 2021, to 3 February 2022. The survey was approved by the GREHTA Ethics Committee and participation was voluntary and anonymous. Multiple logistic regression models were constructed to identify the challenges of telehealth. RESULTS: 1753 physicians' responses were gathered. The responses came from physicians from different Latin-American countries, as follows: 24% from Mexico, 20.6% from Argentina, 14.7% from Colombia, 10.9% from Brazil, 8.7% from Venezuela, 8.2% from Guatemala and 3.2% from Paraguay. Responders with a high interest in carrying out their assistance task through remote telemonitoring reached 48.9% (821), while 43.6% are already currently conducting telemonitoring. A high number, 62%, claimed to need telemonitoring training. There is a direct relation between higher interest in telemonitoring and age, medical specialty, team working, residence in the biggest cities, expectations regarding telemedicine and reimbursement. CONCLUSIONS: Remote monitoring is feasible in Latin-America. General practitioners and specialists from bigger cities seem eager and are self-perceived as well-trained and experienced. Facilities and resources do not seem to be a challenge but training reinforcement and telemedicine promotion is necessary for those physicians less motivated.PLAIN LANGUAGE SUMMARYWhat is the context?Hypertension is one of the leading worldwide modifiable risk factors for premature death. Strong evidence supports that effective treatment of this condition results in a significant reduction of hard outcomes.Only 20%-30% of hypertensive patients are within the blood pressure targets recommended by guidelines in Latin-America. There is an urgent need to implement innovative strategies to reverse this alarming health situation.What is new?Latin-American physicians were highly predisposed to telemonitoring practice. This high motivation was not influenced by hardware or software availability, technological knowledge or experience, by volume of monthly consultations, or by area (private-public) where the care activity is carried out.This high motivation may be supported by the conviction that this practice could be very useful as a complement to face-to-face assistance and a highly effective tool to improve adherence even though respondents considered that just 10% of the patients would prefer telemonitoring over office consultation.What is the impact?Facilities and resources do not seem to be a challenge but training reinforcement and telemedicine promotion is necessary for those physicians less motivated. The general perception is that it is necessary to move forward to resolve legal gaps and financial aspects.Physicians must adapt to changes and develop new communication strategies in a world where the unrestricted access to teleinformation makes patients self-perceived as experts.

摘要

目的:评估拉丁美洲医生对远程血压监测和远程医疗在高血压管理中的看法。

材料和方法:对居住在拉丁美洲的医生进行横断面调查。该研究由墨西哥高血压专家小组、美洲高血压学会、美洲心脏病学会流行病学和心血管预防委员会以及墨西哥国家心脏病学家协会进行。从 2021 年 12 月 7 日至 2022 年 2 月 3 日,使用 Google 表单进行了一项包含 40 个问题的在线调查。该调查得到了 GREHTA 伦理委员会的批准,参与是自愿和匿名的。构建了多个逻辑回归模型来确定远程医疗的挑战。

结果:共收集了 1753 名医生的回复。回复来自不同拉丁美洲国家的医生,具体如下:24%来自墨西哥,20.6%来自阿根廷,14.7%来自哥伦比亚,10.9%来自巴西,8.7%来自委内瑞拉,8.2%来自危地马拉,3.2%来自巴拉圭。有 48.9%(821 人)表示对通过远程远程监测来完成他们的援助任务非常感兴趣,而 43.6%的人已经在进行远程监测。有 62%的人声称需要远程监测培训。对远程监测的兴趣与年龄、医疗专业、团队合作、居住在大城市、对远程医疗的期望和报销之间存在直接关系。

结论:远程监测在拉丁美洲是可行的。来自大城市的全科医生和专家似乎很热心,并且自我认为经过了良好的培训和经验。设施和资源似乎不是一个挑战,但对于那些积极性较低的医生来说,加强培训和推广远程医疗是必要的。

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Analysis of the virtual healthcare model in Latin America: a systematic review of current challenges and barriers.

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