Managing cardiovascular risk factors with telemedicine in primary care: A systematic review and meta-analysis of patients with arterial hypertension and type 2 diabetes.

IF 1.8 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Chronic Illness Pub Date : 2024-08-28 DOI:10.1177/17423953241277896

Matic Mihevc, Tina Virtič Potočnik, Črt Zavrnik, Zalika Klemenc-Ketiš, Antonija Poplas Susič, Marija Petek Šter

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引用次数: 0

Abstract

Objectives: To review the effect of telemedicine interventions on cardiovascular risk factors control in people with arterial hypertension (AH), type 2 diabetes (T2D), or both in primary care.

Methods: We conducted a systematic review in February 2024 using PubMed/MEDLINE, Cochrane Library, and EMBASE databases. We included randomised controlled trials from 2010 onwards, lasting ≥3 months, comparing telemedicine to standard care for managing cardiovascular risk factors in adults with AH, T2D, or both.

Results: Among 1803 records, 54 were included. Telemonitoring with teleconsultations showed the best outcomes. For AH, systolic blood pressure decreased by -5.63 mmHg (95% CI -9.13 to -2.13) at 6 months and -5.59 mmHg (95% CI -10.03 to -1.14) at 12 months compared to standard care. For T2D, HbA1c decreased by -0.45% (95% CI -0.90 to 0.00) at 6 months and -0.18% (95% CI -0.41 to 0.05) at 12 months compared to standard care. Blood glucose self-monitoring was as effective as telemonitoring for T2D at 6 months. The effect on diastolic blood pressure, low-density lipoprotein, triglycerides, and body mass index was non-significant.

Discussion: Telemedicine offers short-term benefits but lacks long-term effectiveness. Optimal outcomes require a combined telemedicine approach, health education co-intervention, ≥12-month follow-up, and careful patient selection.

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在初级保健中利用远程医疗管理心血管风险因素：动脉高血压和 2 型糖尿病患者的系统回顾和荟萃分析。

目的综述远程医疗干预对动脉高血压（AH）、2 型糖尿病（T2D）或同时患有这两种疾病的初级保健患者心血管风险因素控制的影响：我们于 2024 年 2 月使用 PubMed/MEDLINE、Cochrane Library 和 EMBASE 数据库进行了一次系统性回顾。我们纳入了 2010 年以来持续时间≥3 个月的随机对照试验，这些试验比较了远程医疗与标准医疗在管理患有 AH、T2D 或同时患有这两种疾病的成人的心血管风险因素方面的效果：结果：在 1803 份记录中，54 份被纳入。远程监测和远程会诊的效果最好。与标准护理相比，AH 患者的收缩压在 6 个月时下降了 -5.63 mmHg（95% CI -9.13-2.13），在 12 个月时下降了 -5.59 mmHg（95% CI -10.03-1.14）。对于 T2D 患者，与标准护理相比，6 个月时 HbA1c 下降了 -0.45%（95% CI -0.90-0.00），12 个月时下降了 -0.18%（95% CI -0.41-0.05）。在 6 个月时，血糖自我监测与远程监测对治疗 T2D 同样有效。对舒张压、低密度脂蛋白、甘油三酯和体重指数的影响不显著：讨论：远程医疗具有短期效益，但缺乏长期效果。最佳结果需要结合远程医疗方法、健康教育共同干预、≥12 个月的随访以及谨慎选择患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Chronic Illness Multiple-

CiteScore

3.80

自引率

0.00%

发文量

期刊介绍： Chronic illnesses are prolonged, do not resolve spontaneously, and are rarely completely cured. The most common are cardiovascular diseases (hypertension, coronary artery disease, stroke and heart failure), the arthritides, asthma and chronic obstructive pulmonary disease, diabetes and epilepsy. There is increasing evidence that mental illnesses such as depression are best understood as chronic health problems. HIV/AIDS has become a chronic condition in those countries where effective medication is available.